Plan of Care

navigating through nursing school

Tag Archives: nursing

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.

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.

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.

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.)