Plan of Care

navigating through nursing school

Tag Archives: nursing school

Ending Yet Another Hiatus (I Hope)

Yes, I know, I know, I suck at blogging. I’m not sure I actually have any readers anymore, so it likely doesn’t actually matter, but — my summer classes kicked my ass pretty thoroughly. (Organic chemistry? Hell.)

I’m going to give it a third, fourth, something like that go, though. I occasionally even have things to say! Up and coming: a rant/statement on how I much prefer “patient” to “client” in healthcare despite the intention of empowerment behind “client.” But it’s a messy and hard thing to talk about.

But I do have Thoughts on it, and those are thoughts that want to be written down. And where else to do it but here?

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I feel like I write about roads more than about school these days

So I was all set to write about yesterday morning’s pre-first-day-of-clinical mishap (because my life is a series of anecdotes about mishaps; I’ve yet to have anything notable to say about any of my actual classes except for a couple of amusing quotes from professors) as soon as I got a chance to write anything at all when this past hour happened and dictated that I write this down first before I forget it.

Last night, it snowed. This is something of no consequence to where I live. I live in a place where serious winter weather happens as often as it doesn’t in Florida, and to about that extreme. Between December and February the average outdoor temperature is 9º Fahrenheit. It snows daily. Today when I went outside at 10:15 the large bank thermometer was reading 15º. It snowed about four inches, and to someplace where everything is always open, regardless of the ridiculous blizzard or whatever, I didn’t even think to check my student e-mail before leaving. Who closes a school when there’s only four inches of snow? This is a school that was still going for the first two days into a disastrous ice storm a few years ago that left several entire counties without power and left me fleeing to my parents’ 150 miles south for about four days. (If that identifies my school to you just from that one statement, I’m not actually surprised in the slightest.) It literally had not occurred to me at all that school might be closed. Snow hasn’t equated to “day off” in my head since high school. This college never closes. Snow meant “I have to be ready to leave earlier than usual because I have to sweep snow off my car, isn’t that a pain”. I complained about the having-to-sweep-off-the-car issue, got ready to go and went outside.

The major road I live on was, miraculously, plowed. I’ve had to go to school on days when said road had not been even slightly plowed and today it was mostly clear; this indicated the rest of the drive would be smooth sailing. And it was! Until I got to school, where in trying to turn down the road that led to the parking garage, my car slid up and down a few times in a giant slush-drift. I switched it into the lowest possible gear and rocked back and forth a little bit, discovered there was no way I was getting into the garage as it involved going up a hill that was covered in about 3 inches of dirty snow, attempted to drive around the school on roads that were also not plowed (on school property) and realized that it seemed that the parking lots were not only not plowed (they clearly had smooth, white snow in them) but that the parking lots were entirely empty.

That was when I realized perhaps not checking my e-mail before I left had been a major oversight.

It simply hadn’t occurred to me that the school that is open when no one has plowed the major interstate that 50% of students at least use to get there might have closed when all the highways and expressways were clear.

So I drove all the way around to the main parking lot, which had a few cars in it (likely all maintenance staff, I figured, and later found out I was mostly correct – a couple may have been teachers) and was still basically covered in pristine snow, found a spot I could pull close enough to the building to that I would be able to get Internet signal, pulled out my trusty 9.1″ computer, prayed I would actually get wireless signal and opened my email, propping the computer up against the steering wheel.

Where I found not one but four emails, the first of which was sent at 5:31 am, indicating that the school would be closed until noon because they didn’t have plow service before then (my reaction: what? You’re open when the roads aren’t even plowed yet because you always have plow service). My one class today was scheduled to end at noon. The clock on my car read 10:44.

Putting away the computer, I realized there was no way I was going to be able to easily get out of where I had pulled the car in. Just because that section of the lot had a clear access road didn’t mean the rest of it wasn’t, well, snow. And I had ended up about halfway in the snowdrift created by the plow that cleared the access road. Switching the car between its lowest gear and reverse about five times, slowly rocking back and forth until I could reverse the car and drive in a circle to make it back to the access road, where another car pulled in just as I was trying to pull out, so I had to reverse back into the snowdrift for a second and force my way out of it again.

While doing that, my low fuel light came on.

at least I got the WordPress app for Android

Which is what I’m currently using as my computer is still packed away in a bag from having been visiting with my parents. I knew if I didn’t update about this now I would never do it ever – this day was quite something.

After departing for the 3 hour drive home at 6am, I was tired when I finally got to my apartment, but as the semester is about to begin there were some things I had to get done right away: be sure the order for my new glasses was in, get my clinical assignment and pick up my textbooks.

The glasses went off without a hitch, but when I got to the clinical assignment part I found a problem: I was given evening shift. Which wouldn’t be a problem if it weren’t for that pesky 4pm language class! I had forgotten the golden rule of “leave your whole clinical day open, you don’t really know your times until it’s begun.”

So there was some frantic switching around of classes until I got into a different sign language section – that has left me with a Wednesday from Hell even longer than last semester’s (no breaks between some pretty intensive courses and labs, 10am to 5pm – in that time I usually have three meals, being a six-meal-a-day person) but at least I got in at all and the books were the same so I hadn’t wasted that prepack order and won’t be losing the credits.

Just as I thought everything had worked out okay, I bit into the snack I had purchased in the bookstore and heard the horrible crack of one of my back molars breaking.

I spit the piece out. It’s in my refrigerator, just in case.

The dentist (who I have spoken to, I’m not an idiot I swear I called him – funny, I’ve been hiding from dentists for three years and now I keep needing one, I had a bunch of work done earlier this month) isn’t open until Monday.

School opens Monday.

This semester is going to be wonderful.

it’s almost over!

Quick update: I have managed to pull my disastrous grade up at the last minute, after today’s exam. (I actually had two exams today; now I’m finally done with hourly lecture exams and only have the four finals and two clinical shifts left to go.) I am very, very tired. I hope that I’ll ever get the ability to recount events from my first semester again.

Part of how I haven’t been blogging enough, though, is that I also haven’t been reading enough. I never feel inspired to share when I’m not looking at the things other people are sharing. Little minutiae? I have Dreamwidth, Livejournal and Tumblr accounts for that in addition to Twitter. Thinking about having my nursing-related tweets actually ported in as entries, but I think that drives a lot of people crazy (I know it does on the sites where I do my more personal, semi-private writing; I’m one of the people who doesn’t like it because it feels largely like it’s all half an IM conversation) … not sure if it would drive people crazy when all the tweets were 100% related to blog content: moments relating to school or nursing-related links. I do a lot of “I liked this article on nursinglink or scrubsmag or medscape or something like that” tweeting.

This paragraph is running away with me. The point is now that I’ve done two major exams in one day and gotten 90s on both of them, I’m treating myself to a tiny break and just … reading other blogs. I’ve already come across a post I can’t resist linking:

you’re a bad, bad nurse, on when nurses call in sick.

Not that I can think of anything intelligent to say on it, because I’m tired. But it’s a good post. I agree with everything in it.

And now I should probably do a little bit more reading and then go to bed, because I’ve got to get up at 5am to get to clinical tomorrow on time. In the snow. Without my GPS for the first time (I still get lost too easily trying to find this hospital; it is not close by). Who hates winter? That’s right. Me.

what, subconscious

Lots of things to update on that I keep running out of time to comment on (and this week, considering the paper, presentation, exam, CPR recert and all the other homework, isn’t really the time) but this is another one of those ‘I should note it so I don’t forget it and I have time right now‘ sorts of things.

I had a nightmare last night that I showed up to clinical this Thursday late, with no paperwork, no ID (this is actually a problem for real, as I don’t have any photo ID right now) of any kind, wearing some weird pyjama getup instead of my scrubs, and without a stethoscope.

Then my boyfriend and one of his former classmates showed up attempting to convince the hospital that they were students for some energywork class that didn’t exist. So a classmate of mine (who isn’t real) and I literally pushed them out the door, just to ask them to come back in and help us move a patient.

I have no idea.

tricky test question

I literally just had the test and am in a lecture, but couldn’t possibly wait to share this question as I was afraid I would forget it. It’s one of the most cleverly written exam questions I’ve ever encountered.

#. Which procedure is correct to follow when listening to breath sounds?
A. Auscultate the anterior chest at 6 different points.
B. Use the zig-zag pattern to listen, comparing sounds from right to left.
C. Ask the patient to take a deep breath and hold it in so you can listen.
D. Instruct the patient to breathe slowly and deeply in and out through the nose.

If I didn’t know before that my instructor wrote NCLEX questions (not examples, but the actual NCLEX) I would definitely know it now. I’m very impressed by the sneakiness of this question’s wording! If not reading carefully you’d definitely be screwed on this one.

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.