Plan of Care

navigating through nursing school

disjointed post

My previously comfortable, low-key schedule (meant to contain nursing classes and Anatomy & Physiology, totaling 8 credits and about a million lab hours, plus a clinical rotation) has been completely destroyed by the addition of Microbiology, attempt #3. Every single time I’ve tried to take this class I’ve ended up sick and unable to complete, and so I don’t like the omen this is creating, but it’s a co-requisite to nursing classes and I’ve got to get through it. I like the course material, mostly (there are some instances that are painfully boring) but my trouble with my left eye makes microscope work tedious and sometimes impossible. Which leads to me being terribly down on myself for otherwise being capable.

Our first skill exam was yesterday morning and I passed; there isn’t really a “doing well” or a “not as well,” so much as just “passing” and “failing.” I’m actually afraid of the next one, which is the complete bath of a patient and making an occupied bed (at once). This is a ridiculous thing for me to be afraid of; IV insertion? Administration of medications? No problem. Intubation? Easy as whichever pastry you choose, I’ve done a million of ’em. Making a bed? Get me away! I can’t even make my own bed. And as far as the entire thing goes, I’m 5″ and 80some pounds; the manikins are bigger than I am, and what may well fail me is not being able to move them in a way that is the most comfortable for a real patient. Obviously, with a real patient, I would get assistance. I can’t so much do that on a skill exam.

Most schools, as far as I’m aware, don’t do skill exams like ours do; hopefully I’m not risking identifying myself. Much.

Despite the scary bedmaking (I know, I’m pathetic) and the additional class making my schedule merry hell because it’s a night class and getting to school at 7am on Monday and leaving at 11pm is a little bit wretched … the worst part of all of it is probably the commute.

At various times, I have: experienced a drive home spending 15 minutes straight with my foot on the break in one spot, been caught at a single red light for 10 minutes, nearly gotten into two separate accidents (neither of which are my fault), forced to park across the street in a pile of rocks and mud behind the grocery store, driven through major construction in the rain at rush hour, left 45 minutes before my class began and still ended up late because of a lack of parking, and other such delightfully pleasant things to experience when I’ve only had a drivers’ license for two weeks.

I’m sure I’m actually forgetting a million (un)pleasant such driving experiences. Really, I’m only posting so I can have posted something and can have even remotely mentioned the terrors of the commute; if I felt awake, it’d be a better constructed post.

But I have homework to do.

Working through the worries (or, I am a neurotic girly-girl); Orientation Day

Today is Orientation, and so of course immediately in sets my particular brand of organizational panic: that being that everything I needed done in advance is, of course, not done. Case in point: I can’t find things and my parking sticker is not properly affixed to my vehicle.

Why? I don’t properly know. Because I hadn’t done it before now. For me this task includes cutting, something I’m fairly bad at doing in a straight line, so I need Boyfriend to help. Boyfriend is annoyed at my morning-person tendencies as of late and is completely ignoring me by way of getting out of bed just to go back to sleep on the couch. I don’t entirely blame him, but here I am, helpless, because he is the tailor and it is his damn rotary cutter that I need to use to cut the transparency that the nice Staples people gave me for free in order to have something to stick the sticker to that is not being permanently stuck to the window of the car, which only theoretically belongs to me (I still sometimes have nightmares that my dad will just casually ask for it back. My dad is buying a new BMW, he doesn’t need my six-year-old Toyota, although he does borrow it when in my area). Maybe I should ask Boyfriend to wake up and help me cut the transparency and stick the sticker on. It’s not like I actually know how to use the rotary cutter. And being able to park legally would be a plus.

Then immediately I realize that something is wrong with the picture over by my mirror. Namely, that my eyeshadow and concealer are both gone. They are not on the floor right by the mirror, or in my purse, or in the ensuite, and I never keep makeup in the properly-sized bathroom. Check anyway. Nope, no makeup there. I really need the concealer because it is also my acne medication, and without it I have let’s say a lot of problems with my face looking as if it’s entirely made of bumps. Not a good plan in my book. Frantic looking for concealer yields nothing.

And I haven’t had breakfast yet. Or taken a shower. I have over twenty inches of hair, it takes some time to dry, and I can’t go over it with the iron (which I need to prevent my frizz attacks in reaction to any weather over 50 degrees) until it is actually dry. I should eat breakfast before I take the shower, in case I do something weird like get food in my hair, which is actually not all that weird when I haven’t trimmed my normally cheekbone-length bangs in three weeks and they sometimes dangle into my mouth. I should probably add “trim bangs” to the list of things I haven’t yet done today.

Having gotten distracted thinking about the bangs I won’t trim until later tonight anyway, I’ve managed to forget what else I was supposed to be worrying about. Not sure if I’m going to bring my netbook or not; after all, I have no sleeve for it and I’d hate for it to get chipped. (It’s new. RIP, old netbook that fit in the sleeve I had, I will miss you and hope you manage to be repaired by a parent who can use you.) But I wasn’t focused on that before, I was reminded of it letting my eyes roam across my dining area to where the netbook was hanging out on a chair. I think I was busily worrying about what shirt I was going to wear, and if it was okay to wear my knee-high boots because they’re the most supportive shoes I have and I’m having a very bad foot week, and then concern over coordinating eyeshadow I can’t find with a shirt I haven’t identified, and only then did I manage to start thinking about jewelry, and then paused full-stop to realize how much of a girl I am.

I should probably go eat breakfast. Take a shower. Make sure all the stuff that needs to be in my purse is actually in my purse, not forgetting my CPR card this time. Pick out clothes. Don’t put them on. Find coordinating makeup. Put that on first. Then put on clothes. Then take hair down from towel. Sit on porch until hair is dry enough to iron, then iron. At some point in this hope that Boyfriend has dealt with the vehicle tag’s being cut and then find some tape to affix it to the car. Fret over shoes. Give up, find socks, wear knee-high boots anyway because in medical fields your feet are an important investment. Continue racking brain to attempt to remember where I was going to go before my orientation (after is easier: grocery store, parallel parking extravaganza, maybe Staples, definitely drugstore, probably somewhere else that has just slipped my mind), give up, leave anyway.

That sounds like a decent enough plan.

All of this passed through my mind in the span of about two minutes. It took me ten to actually write it out. I don’t know what that says, either, but it certainly is easier to go back and take it all in when I can stare at it. Thank you, blog. My apologies, readers.

In the News

Jut some health-related stuff I’ve read recently. I try not to link to, like, the entire New York Times health section, so I cut down on my linking tendencies a lot when I moved blogs. (I used to do things like … link to a good third of the New York Times health articles.) There are three, because usually when I link news items I go for three (sometimes five). Today it’s technically three and a half.

11 years old, on the pill and sexually active? The media loses the news again – an article explaining that 11-year-old girls are taking contraception, but it’s not why the mainstream media wants to jump to make you think. This quote stands out:

Taking hormonal contraception is, for many girls, a means of ensuring they don’t miss school.

Yes. While I hate to insert personal takes on my news generally, here, I can’t resist. (Blogs are supposed to be somewhat personal, right? … Right?) This is me, but my parents, unlike the parents of these 11-year-olds who are heavily involved in the decision, didn’t want me to take estrogens until I was an adult. So I had worsening medical problems until about a year ago, when a practitioner explained to me why it is that I was so disabled 7 days in 28, that it was causing neurological issues and that I needed to be put on medication to control it. So I sure know how it feels to be one of those kids who need hormonal contraception for reasons besides, say, contraception.

Taking hormones can be scary, and in some ways can be dangerous, and yes, it does increase the risk of stroke (this is something that really concerned my mother, which is part of why I waited until I was on my own).

There’s one more quote from that article I want to include, just because, well, it scared me.

During the course of today I’ve spoken to 15 journalists, mostly working for radio and TV news stations, and 13 of which have been male.

Through these conversations I discovered none of the journalists knew hormonal contraception had medical uses. All of them assumed hormonal contraception was simply used to prevent pregnancy. And because of this assumption it hadn’t occurred to them to find out what else hormonal contraceptives might be used for.

Really? Really?

A Heart Pump Ticks Down, and a Stranger Steps In to Help – I love Denise Grady’s pieces most of the time, and they are usually straight-up facts about what’s going on in the health world. This article about heart pumps and their uses includes a feel-good story with an unexpectedly happy ending (I expected a happy ending; I didn’t expect an ending as happy as I got!) and a look at the marvels of medical mechanics.

I didn’t know much of anything about these assist pumps before, and reading the article made me want to learn more. Our star’s pump gave him his own little miracle – the fact that it continued to function well past when they expected it would, giving him almost an extra hour of clot-free living – but the real miracle was the efficiency that the hospital’s nurse practitioner found a man to come in and save the day.

Should McDonald’s offer free statins? – This headline just made me start giggling. It’s completely ridiculous, and personally while I completely support drug therapy when it’s needed, I think that McDonald’s actually providing statins to customers is off-the-charts bizarre, but apparently Imperial College London actually did a study offering that conclusion.

Fast food outlets like McDonald’s and Burger King should offer statins to neutralize the elevated risk of heart disease associated with eating cheeseburgers and milkshakes, a new study suggests.

Later in the article they clarify:

The authors don’t suggest that MCDonalds’, Buerger King and their competitors to provide statins to the burger eaters.  But the message of the study is clear, taking statins can lower heart disease associated with dietary fat – total fat and trans fat.

Well, if they don’t, then why start the article like that? Apparently, because it was a good hook. It got people reading it. It definitely got me reading it – and linking it, too.

Another article on the same topic, Burger and a statin to go? Or hold that, please? opens:

Fast food outlets should hand out free cholesterol-lowering statin drugs to their customers to “neutralize” the heart risks of eating fatty foods like burgers and fries, British scientists suggested on Thursday.

So do they, in fact, actually want the statins handed out with the food after all? Who knows. I don’t. This article continues with,

“Complimentary statin packets are prone to … give Quarter Pounder consumers a sense of false security,” [Dr. Messerli] told Reuters Health by email.

My reaction to that has got to be another really? Do you think? Complimentary. Statin. Packets?! Not that there’s any way that restaurants handing out prescription drugs is a good idea. I think Reuters’ experts may have missed that despite how Food Consumer phrased it (and who’s getting reliable medical news from a website called Food Consumer, anyway? I can understand getting reliable food news from Food Consumer …) the British study isn’t literally saying that.

I think.

Considering it’s been contradicted enough times. First they said it, then they didn’t. I’m confident they didn’t actually mean that restaurants should be handing out prescription drugs, but the responses to it make it sound like not everybody is convinced.

If they did actually say that, I’m not going to a fast food restaurant in the UK anytime soon. Or asking Imperial College London for pharmaceutical advice.

Griping about it may yet be the way to go

As after yesterday’s post, I looked at the available class seats for that one class I still needed (or I would lose my entire course schedule), and miraculously found that there was one (and exactly one) seat available that fit perfectly into my schedule.

Unfortunately that means that my Mondays begin at 6:30 am and end at 10:35pm, but that’s what I get. It’s not so bad.

Of course, then I was dumb and went to get my Nursing I manual bound so I didn’t have to put it in a binder … and now have a nice, professionally-bound manual that has all of my lab sheets bound permanently to the back of it. Sigh. I don’t want to have to have it bound again (it’s very nicely done and was only $3; Staples, I will never doubt you again!) but getting the pages out is somewhat of a difficult task. It’s a good thing Boyfriend has a rotary cutter, I guess.

Some days I just don’t know what to do with myself. Usually I sit on doing things for ages and meticulously plan. Today I decided I’d just go out and get something done … so of course the something was something that ended up not being the best move ever.

I’ll live.

More About Stuff

Well, first of all, my schedule is turning into a complete disaster as I learned microbiology is actually a co-requisite of everything else I’m taking, and there are currently, yep, no seats available. I might therefore lose my entire fall schedule and be stuck in school another year! Oh, life.

I don’t want to dwell on that, though. It’s so terribly discouraging. Instead, this is me talking about my supplies – today I went and picked up my textbooks.

After experiencing the sticker shock of the email telling me that they were ready, that would be approximately $600.

WTF? I say. My parents agree (they are the ones stuck paying for my books, as I really don’t have $600 to throw around – I don’t even have $90 to throw around). Needless to say, okay, better come up with $600. Thanks to my mother, that wasn’t too hard, and so today I went to the store to pick up Prepack #52.

It looked like this: (this image is a thumbnail)

Okay, no. Admittedly, it did not include the background contents of my desk, also pictured.Not the phone, not the page-a-day calendar currently displaying the wrong date, not the snowglobe. All those books, the lab manual on the bottom, the dissection kit and the glasses, though. And my school’s manual, which while I took a lovely photo of it is not included for anonymity purposes.

In order to make it easier to see what the books are (as somewhere someone might care, or wish to compare my educational institution’s , I provide another image:

My parents agreed it was actually pretty worth the $600.

this post ended up being about me

Mystery Illness is really kicking me when I’m down, right now, and so I actually had to drop my microbiology class because of how I kept having to be in and out of the hospital. Isn’t that a great way to start health care career #3? By being in and out of a hospital? Today I spent four hours trying to get an anti-ribonuclear protein test done. Apparently only “antiquated” doctors request this test anymore. I thought that was funny, since one of the doctors in question is in his late thirties and the other one happens to be my dad.

Not knowing what’s wrong with me aside, though, I’m trying to remind myself I have this blog here, and even if it doesn’t have readers, it’s okay to update it! (No, I don’t have a clue how to publicize my blog. I’m not sure if I want to, but I do like having people to talk to; I read lots of nursing blogs, I’m just too socially awkward to ask for a link exchange. If you’re here reading this: hi.) My little-bit-out-of-it-ness will hopefully end soon. And I am getting excited about the start of school!

I got a haircut, reinstating my bangs to attempt to make myself look older than twelve, something I often get in the ED when all geared up in my EMS clothes. “You can’t do that job, you look like you’re twelve!” I’m twenty-one, thank you, and I think with my bangs back for the first time in six years I probably look at least 18. On good days. Of course, I’ve promptly failed at keeping the hairstyle as nice as it was because of an inability to blow-dry my own hair, but my hair isn’t that important. My hair isn’t really about nursing. It is part of getting excited for the semester, though!

I also got my uniform, which I won’t include pictures of, because it identifies my school, but miraculously it has scrubs that fit me. (I don’t know if I’ve mentioned how extremely small I am. Well: I am extremely small. The world is designed for people much larger than I am. It contributes to folks thinking I’m twelve. I’m too short for my car, which was purchased with my height in mind. It is the smallest automobile I could find and I still sit on two pillows to drive it.) We were required to get another stethoscope, which made me want to scream because I have a Littmann Lightweight and why would I want to use something of lesser quality? but my new Sprague #122 is okay because it’s purple (my old SpragueLite is blue and my Littmann is green) and offsets the school uniform nicely, and I can understand (kind of; my old clinical programs did not do this) them wanting us to match. Plus scissors and a stethoscope nametag. Shopping! Exciting! Normally I really, really hate shopping, but I really like ‘stuff’ (as you may be able to tell by the fact the first post in this blog is all links about scrubs) and so I had a good time getting these things. It was a bit ago.

The SHOES, though. The shoes are going to make me mad, because like the stethoscope, I already had what I thought was perfect: a pair of Danksos Professional Clogs. Unfortunately, I learned at the last minute at the uniform store that nursing students have to wear white shoes. What? I’m sorry, I’m a neatfreak. I can’t wear white shoes. I will be polishing them every twenty minutes. The white shirt is bad enough — really, I can’t just wear my brown Danksos? I came out with Cherokee Robins, which are very nice, but … they’re white. And no one will sell me a gallon of shoe polish.

To suddenly change the subject and make this post even more disoriented than it already is, I also got my letter today informing me that my orientation is Thursday, August 19. Nice to know. I get to pick between two times and I’m sure not sure which one of them I like better! I have no idea what I’ll be doing then. Except, apparently, not going mountain climbing with my dad like I thought I was. The sacrifices one makes for school, of course.

In that letter, they identified the textbook as Fundamentals of Nursing, which I’m sure surprises no one, but despite having put in a textbook order at the college bookstore (that also includes my A&P books and whatnot) I figured I’d scout around online and see how much it cost, expecting some sticker shock. I was pleasantly surprised: it’s averaging at about $90.

That’s a small favor.

(My attempt to certify my county residence and knock $10k off my tuition, on the other hand, was rejected. I filled out the residence forms and got them notarized too early. This place is very strange sometimes.)

It’s official: microbiology is suddenly boring.

I find the topics completely fascinating, I love learning about microbes of all sorts and causative agents of disease and why things are the way they are. But a week and a half into the class (and okay, I missed two classes due to my current raging Mystery Illness) I am absolutely bored out of my mind. The first major exam is in two hours and I’m staring blankly at all my practice quizzes, getting everything wrong because I’m so bored all the words are swimming around.

Despite my passion for infectious disease, I can’t get into the early stuff. It used to come naturally, but now it’s a pile of dull that doesn’t stick in my memory.

Excellent.

uninteresting update

In my usual greatly productive and lucky fashion, I have now missed two microbiology classes in a row and one lab session due to being ill. Which gets me a zero for today’s lab, at least. I have a test on Wednesday; hopefully all the missed lecture time won’t make that much of a difference. I should be in class now.

Instead I’m typing this entry with my eyes shut as the computer screen is too bright. My pupils are still dilated and burning like crazy from all the weird chemicals put in my eyes. This is what I get for spending five hours (five hours) at the neuro-opthalmologist.

On the other hand, I got my student subscription to the ANA’s NursingWorld. This unfortunately doesn’t make me an actual member of the ANA – I wish it had! – but it still has some pretty neat perks. I’m still playing with it.

And hoping that depending on how things go in the next week, my summer schedule will be sorted enough I might get to find out if I can get some kind of job.

too small a workload?

In my last two semesters of college, I’ve had courseloads of 22 credits for Fall 2009 and 18 credits for Spring 2010. This summer, I’ve got one class (microbiology) that counts for the current degree I am nearly complete with as well as my ADN, as well as two other courses, giving me a load of 10 credits, but hey, it’s summer and I’m going to be working six days a week (Sunday-Friday) as well.

So imagine my horror when I get my schedule worked out for Fall 2010 and discover that I only have a load of 8 credits.

And I do, in fact, mean horror. The best way to get something done, as many people including my father yesterday evening have said, is to give it to a busy person. I operate under momentum. The more I have to do, the more I do, and I never take breaks, because if  I stop it’s the next day before I get going again. I work through and work through and finish and then relax.

So what on earth am I supposed to do with no classes on Tuesday or Friday? Admittedly the classes I’m in are Anatomy & Physiology and Nursing I, neither of which are walks in the park, but suddenly I’m cursing the fact that my previous degree has me entering nursing school with more than half the classes done already.

I might need to take some non-required electives (that won’t even count for anything, as I have all my required electives done) just so that I don’t start failing exams because I’ve got too much downtime to remain able to retain information and stay focused.

“Too little work” is not a conundrum I ever thought I would find myself in. And yet, here I am, wishing I had a learning style that allowed me to sleep every now and then.

The Well-Attired Worker

Since I haven’t started nursing classes yet (that begins on May 24 with microbiology) and while I am currently in clinicals, my clinicals are for different healthcare training that I graduate from on May 22nd, I can’t really get to posting anything about nursing school yet. But I wanted to post something, so I got to thinking. My mind went back to a trip to a uniform store to pick up my beautiful stethoscope, a Littmann Lightweight II SE that I’d been coveting for over a year, since my time in the hospital work sector had begun. It’s not the stethoscope I was thinking of posting about, though the stethoscope is a beautiful thing in and of itself — it’s a pair of scrubs, made by the designer Kathy Peterson under her Koi label, that I immediately thought of. This pair of scrubs was longsleeved and made of a thin, soft brown fabric, with turquoise trim on the pants and a full turquoise T-shirt overlay on the top. Turquoise and brown are a color combination I tend to wear a lot, and they actually had these scrubs in the rarely-found XS size (it’s hard for me to buy anything as a 5’1″ 90-pound weakling), so now that I had bought my fancy, expensive stethoscope as a gift to myself for my unexpectedly high TEAS scores, I had something new to covet.

As I had just purchased a $65 stethoscope I really didn’t have the spare $50 for the scrubs. I’ve got a majorly limited income; going broke on one trip to the uniform store, while entirely possible for someone like me, isn’t all that appealing. Things like eating and having a place to live, unfortunately, outrank stethoscopes, scrubs, shoes, useful gizmos like EKG calipers, study guides and other such gems that can be found at these places. (The only place I can spend more money at in one go than a uniform store is Staples. I’ve got some strange shopping tastes.)

When I was trying to think of something to post about, though, that’s where my thoughts went — and just as I was sitting and contemplating if that was really a good idea, a current RN working on the floor I was posted opened up her LiveJournal account and started linking scrubs and other things she’d like to purchase when she had the chance. Well, I thought, if she can do it, I can do it. And I’ll enjoy it. Maybe it makes a terrible first impression of me as materialistic, which I generally am not, or obsessed with fashion, which I am also generally not, but it might be fun. (I’m not big on caring that much about how other people see my appearance, and I actually hate shopping; I love colors, individualism and styles, which is why I’m so big on tricking out my healthcare attire.) Google led me to the Koi website, and I was satisfied I could get to putting up a picture of, or at least a link to, those awesome scrubs. Then I wouldn’t forget where to find them when I wanted to buy them again …

So imagine my horror when going through the entire Koi website brought up no results for the scrubs I had loved so much! The closest thing I could find was a set with an identical design but different colors, which, while better than nothing was not my beloved turquoise and brown. (The more I write this the more pretentious and materialistic I feel.) At least now I know they still have that design, and those colors aren’t bad. And at least I know what I’m doing: making an entirely consumer-whore type post about stuff I like.

Hunting for other nice scrubs gave me more than scrubs to look at, though. An internet prowl brought me to a nursing site called Scrubs: The Nurse’s Guide to Good Living. On that site I found a few really good scrubs-(and-stuff-)related informative posts very much worth sharing, like:

They also have an interesting series called The Perils of Beauty discussing a nurse’s image and wear, as well as something that reminds me of the more serious edition of a Cracked top ten post: historic nursing uniforms (the good, the bad and the ugly).

So now that I’ve rambled a bit and provided a whole bunch of links from an interesting site I found entirely by accident, I’m not entirely sure where I was going with this. Originally, I was just going to be talking about a pair of scrubs; that didn’t work out. I considered just linking a bunch of stuff I wanted, but that seemed too materialistic and self-centered. Now I’ve got some more informative links, and so I guess the best way to close this off is to share some of my own favorite “stuff”: scrub brands like Koi, from earlier, but also Dickie’s, which I currently wear (in solid colors — I wish I had things like the Spring Prints); Cherokee, which I’ve seen a lot of nice things from (and who are kind enough to also have things for less), and the awesome pony(tail) scrub hats from Blue Sky Scrubs, which I absolutely need some of — OR hats really don’t accommodate my hair, and I’ve got to stand in on a C-section tomorrow. I don’t think I can get one in time.

Now if only I knew yet what our school’s scrub uniform looked like. Then I could get on to talking about that.