In the Spirit of James Herriot

We Bribed Santa with Cookies

2010-12-16T08:58:00.001-08:00

I kid you not we had to plaster him with gingerbread men to get him in our photo.

Park Crest Play Area

2010-12-15T14:36:00.000-08:00

Fall semester has finally just come to an end. This video details a project we completed for our community nursing project, in which we were asked to identify a health need in our community and complete a project to alleviate the need. We found that none of the mothers at this housing project would take their kids to the numerous parks just behind and across from their complex, because they were used by the local gangs and were a hub of drug use and prostitution. There had also been several kidnappings recently in the area, and many parents worried about the rampant gang activity in the area. Although there were some grassy areas within the complex, the kids were prohibited to play there (because they were expected to use the parks). They truly had nowhere safe to play!

After some long negotiations with the vice president of the property management company, and some red tape from Housing and Urban Development, we were finally able to create a designated play space. We had a wonderful time putting this together with the help of the community's Teen Council, a group of high school students who volunteer their time to the community center at Park Crest.

The day we finally were able to start laying paint, kids and parents from the center slowly filed in, sitting to watch our progress from the sidelines. The Teen Council also really took ownership of the project, and helped us greatly with the layout and all the hard work. The day after we painted, we heard that that very night a bunch of kids came out to play twister, bike ride and enjoy the space. It was a great feeling, and I was so happy to have the opportunity to be a part of the project!

The Dominican Republic

2010-10-23T15:18:00.001-07:00

In the interest of honing my assessment skills and immersing myself in a Spanish-speaking environment (whilst avoiding getting robbed again in Mexico), I'll be spending a week and a half of January working in a small community in Peravia, in the Dominican Republic.

Ah, the sacrifices we make for professional development...

Reflection at the Halfway Point

2010-08-06T22:57:00.000-07:00

Neglected to publish this after I finished last year (half way through my nursing program)... still rings true to me now...

I have cared for over 100 patients, each with his or her own story. I've seen babies born, saved the life of a dummy, flown in a helicopter carrying a heart attack patient to hospital, cried with patients, cried for patients, and laughed harder than either of those. I've heard colleagues' stories of opening the first children's hospital in Uganda and assisting in life-changing cleft-lip surgeries in Cambodia and Vietnam. I've helped someone to smile and forget for a moment on what was the worst day of his life. I've learned what is known about how the body works, and come to appreciate the many mysteries of both the body and spirit that are beyond comprehension.

I have met some of the greatest people I have ever known- in my classmates, faculty and patients. Each of the students in my program is completely unique- bringing different insight into class and clinical each day. I'm always humbled, and frankly, always in awe that I somehow found a place in this group.

There have been risks, hard work, a few near fainting episodes... but I believe this has been the best decision I have made for myself.

Prevention!

2010-08-04T22:50:00.000-07:00

A Contemporary Fable
Upstream/Downstream

It was many years ago that villagers in Downstream recall spotting the first body in the river. Some old timers remember how Spartan were the facilities and procedures for managing that short of thing. Sometimes, they say, it would take hours to pull 10 people from the river, and even then only a few would survive.

Though the number of victims in the river has increased greatly in recent years, the good folks of Downstream have responded admirably to the challenge. Their rescue system is clearly second to none: most people discovered in the swirling waters are reached within twenty minutes, many in less than ten.

Only a small number drown each day before help arrives -- a big improvement from the way it used to be.

Talk to the people of Downstream and they'll speak with pride about the new hospital by the edge of the waters, the flotilla of rescue boats ready for service at a moment's notice, the comprehensive health plans for coordinating all the manpower involved, and the large number of highly trained and dedicated swimmers always ready to risk their lives to save victims from the raging currents. Sure it costs a lot but, say the Downstreamers, what else can decent people do except to provide whatever is necessary when human lives are at stake.

Oh, a few people in Downstream have raised the question now and again, but most folks show little interest in what's happening Upstream. It seems there's so much to do to help those in the river that nobody's got time to check how all those bodies are getting there in the first place.
That's the way things are, sometimes.

-- Donald Ardell
High Level Wellness: An Alternative to Doctors, Drugs and Disease

Med-terms during Finals

2010-05-02T20:46:00.000-07:00

Ok, Word, I'll give you esophagogastroduodenoscopy but you should have known ascites.

In other word news, my patient explained to me that she has a condition that none of her doctors have heard of: opioid-induced hyperalgia. "So you have an increase rather than decrease in pain with opiod use?" I asked. She got excited that I was familiar with the disorder, until I had to burst her bubble that I just knew the word roots. No more discussing word etiologies with patients for me- you break it down, you break a heart.

Aaaand....It's April

2010-04-11T21:11:00.000-07:00

...I think I dangled my cliff hanger too long, so I'll sum up the story briefly. The 10am call was to transfer a patient in the midst of a heart attack from his current hospital to one with a cath lab. The cath lab is where they perform things like PCI (percutaneous coronary interventions) like widening a constricted coronary artery with a hollow tube called a stent.

The helicopters are fully equipped with all the machines you might find in an intensive care unit, only in miniature. There is barely room for the nurse, EMT (in this case an MD resident), pilot and patient. I had to sit up front once we picked up our patient to make room. As fun as the group was, once the call came they went right to work. I was thrilled to be part of such a great group, if only for a day.

In other news, school has been intensive. Each Thursday I am now getting two highly acute patients of my own. I feel like my mind never stops working those days- I'm constantly on the alert for medications interactions/adverse reactions/administering them correctly, concerned with upholding universal or other safety precautions, turning patients, fussing with IV pumps or enteral feeding machines, or completing physical assessments and interpreting and charting the results. Throughout it all, I try to put the families at ease and answer their questions without seeming stressed so as not to concern them. My hat is off to the nurses working with 4-5 patients each day. I still just don't have the experience to innately know what to look for and I inadvertently make silly mistakes from time to time. For instance, this last week I neglected to put the bed in the lowest position after I had raised it as high as I could to place an IV. I went back in with my instructor (yikes), and she chided me, "Oh, girly...you DID NOT leave your patient like this." Yes, yes I did. I look forward to the day where I truly feel like it's all under control.

In final news, I ran for Secretary of the Graduate Nursing Student Association this last week...and actually WON! I've always served in student government, but mostly in the volunteer rather than elected positions. I'm determined to leave a positive impression on this school of mine.

Back to studying!

Ok...So It's March

2010-03-05T22:44:00.000-08:00

My New Year's resolution had been to post more frequently, but that went the way of most resolutions.

My excuse is two fold- first, this semester is intense. In addition to a tough lecture, reading and group presentation schedule, I now attend two clinical days- one on my regular medical surgical floor and another day at the county psychiatric facility. I spend one day physically and mentally drained after caring for medical patients and the next day mentally and emotionally drained after watching the psychiatric mental health (PMH) nurses and social workers struggle to advocate for the needs of their patients. So, basically I get a double portion of the brain drain each week.

The PMH patients are uninsured, homeless, and often dealing with advanced illnesses that try the limits of their own and their family's coping skills. The social workers, doctors and nurses are excellent at working as a team with patients in order to get them on their feet and connect them to substance abuse or critical care shelters. However, the governmental funding is sparse for these county centers, and the hospital often reaches capacity. Though many people say mental health nursing isn't "real nursing" and is a pretty light load, I think the emotional strain more than accounts for the lack of running around to complete the day's work.

I could and likely will go on, but I digress from my second reason for blog post procrastination: I was hoping to have a great story with which to kick off the winter quarter of blogging but until now had mostly been dealing with some of the harsher realities of treatment that left me blog-washed (e.g., patients needing but not wanting care, families not respecting the wishes of their fellow family members, the difficulties of needing an organ transplant). Thankfully, this last week was the awesome experience I'd been waiting for...

MERCY AIR!!!!
Our excellent clinical preceptor got each of her students a rotation through this helicopter ambulance service. I met early at an air field to find basically a small apartment on the second floor above a hangar. The staff each day (24 hours shifts for the clinical team) is a nurse (who runs the show), a pilot and either an EMT (or, as it was today, a medical resident).

The group was charismatic up the whazoo and we had a great morning of chomping bagels and sharing life stories up until 10 am when we got our first call...

To be continued...

In-Patience

2010-01-24T10:58:00.000-08:00

In order to help finance my education as well as to enhance it, I spent four days of January as a clinical research subject.

The study's focus was to assess brain function during hunger or fullness, in order to inform treatment of certain eating disorders. I was treated to a four-day, all expense paid stay at Chez Hillcrest, aka UCSD Medical Center. The diet was tough- death by fruit I say, but more than worth it to gain some insight into the experience of patients staying at a hospital. Granted, the experience was a muted version of a normal patient experience in that I was thankfully in good health throughout my stay.

I learned or solidified preferences on how to do certain tasks- check patient ID bands properly, take blood safely, etc. The main take-away point for me however was this: It can be frightening to know that your life is dependent on other individuals. For me, this simply meant that the nurses had to provide my scheduled meals. No outside visitors were allowed and the diet was strictly regimented, so if the staff forgot to feed me or were late to the shift... I wouldn't get to eat. I felt sort of vulnerable having something so fundamental to my survival in another person's hands, and the best nurses to me were the ones who kept me informed and involved me as best they could in the process (e.g., gave me a call bell in case I needed them, let me know when they would be changing shift, gave me the daily schedule so I knew when to expect meals).

I hope to remember this experience as I start my nursing career, and to work to empower and inform patients and family to whatever degree possible.

A Year in a Day

2009-12-30T19:58:00.000-08:00

The pages of my daily nurse quotation calendar are growing slim, which can only mean 2009 is drawing to a close. I'm beginning to appreciate the truism that time passes exponentially fast as a person ages. This year was nothing more than a flash, and I can hardly believe all that has happened in the last year and how close it all seems.

This time warp may be to blame for an experience of late. Finals ended several weeks ago, and I've been going out of my mind trying to fill my days with productive exercises. Five years ago, I would have enjoyed an idle afternoon spent perusing facebook pages or marathon-viewing the latest HBO series. Now though, I just feel like it's a waste of precious time. Or maybe it's that I've waited so long to start my nursing career that a month-long hiatus from the accelerated program feels quizzical and a little cruel.

Furthermore, my nursing quotation calendar ended on a note of toilet humor when I was expecting a gem of nursing wisdom. Geez.

My Nephew!

2009-12-09T15:42:00.001-08:00

With great pleasure, I introduce my new (and only) nephew, Ethan James. It's taken a will of steel to study for finals rather than gaze at him... Ok, so maybe I'm working a little gazing around my study routine. This winter vacation promises to be exceptional.

Nursing Leadership

2009-12-09T15:25:00.000-08:00

Earlier in the semester, we were assigned to write a page on a local, national or international leader in the field of nursing. I recalled reading an article on CNL's that mentioned the role of a CNO in Glendale. Her name is Gwen Matthews, and she had implemented a role akin to the CNL, before CNL became a nursing specialty. On a whim, expecting I might be turned down, I called the hospital to request a short interview with her.

She graciously accepted to speak with me, and I had great conversation with her about the changes she had implemented when she arrived at Glendale Adventist as well as what she sees as pertinent topics to the CNL role now and in the coming years. Her opinion is that the greatest function will be to provide continuity of care for patients following discharge, by implementing telecommunication technologies. These measures, she expects, will greatly reduce the number of hospital re-admissions and improve outcomes for these patients by offering reinforcement to their discharge teaching.

I am so glad I spoke with Ms. Matthews! I plan on visiting the hospital in January to audit their monthly leadership education session. So exciting!

Revision

2009-12-05T18:51:00.000-08:00

Scratch that last comment about a periodontal disease paper. Apparently the instructor meant nursing research, not nursing-related research. So the last few days have been paper attempt #2, on the roles family members take on when their ailing loved one is being weaned off a mechanical ventilator in ICU. We'll see how it turns out. I'm running out of paper steam following attempt #1, and another paper on the medicinal uses of soy bean products.

The end of the semester is in sight! Upward and onward!

It's a Mad, Mad, Mad, Mad Mid Week

2009-12-02T21:21:00.001-08:00

I spent the day writing a research paper (on nursing, periodontal disease and cardiovascular health) while eagerly awaiting news of my nephew's birth. A few hours ago my brother-in-law posted a photo on Facebook of a pot of tepid water sitting on a stove. I like the poetry and subtlety and will assume they are perhaps growing weary of all the attention focused on him and my sister these past several days.

In other news, CR and I took our favorite canine friend Kaffey to the vet yesterday to remove his Kaffey beans. I spent today with him, honing my post-surgical nursing skills (assessing the incision site for signs of infection, administering meds using the 7 rights, offering warm blankets and chew toys).

Tomorrow is my last patient assignment of the semester, followed by observation in the urgent care center next week. Then we have final exams followed by a glorious month during which I plan to catch up on work hours and play with eunich pups and baby nephews.

Getting on with My Nerves

2009-11-21T14:08:00.000-08:00

Monday is an exam on nursing care for patients with neurological injuries. How happy I was to spend some time with old friends from my cognitive science days, Nerv and Willy.

Pokemon Practicum

2009-10-23T20:47:00.000-07:00

My Fridays are typically spent sticking tubes, needles or gauze into dummies.

This last week, however, we skipped the dummy torture in lieu of the real thing... er, real health care practice that is. As flu season descends upon us all with unwashed hands and oozy noses, the community is in need of some prophylaxis and the nursing students of 555 were all too happy to oblige.

Our group of 16 students gave around 500 IM flu shots (and a few nasal meds) at a local free clinic. As we drove up to the parking lot, we saw maybe 30 or so people already waiting in line for the clinic to open. What we initially thought might be an hour at the clinic became a 9-2pm adventure in overcoming needle-fears, practicing broken Spanish, and chatting with lots of friendly folks (who were patient enough to wait 2+ hours after we ran low on adult-sized needles).

We were set up into two students per station. My station partner commented that the set up was akin to a deli line - "NUMBER 33! Jes in the white coat at the end there can help you." Then it was just "(Screening questions) *swab, poke* Thanks for coming!"

It was a great opportunity for extra practice and experiences. Best of all? Free thermos from the grateful clinic staff!

Heard in Class

2009-10-12T18:22:00.000-07:00

After a thoughtful yet round about discussion on rectal suppositories - "Look, honestly, there isn't a day that goes by that I don't have my finger up someone's butt."

To a class of new nursing students: "Remember - as nurses our job is to do no harm. Maybe you can't do anything good... but at least don't harm the person."

"Sometimes we don't give fluids with an enema, but just apply to the tube to release gas buildup. You put the other end in water...and well, it's just like a little boiling cauldron."

"Happy birthday! I made you stoma cupcakes!"

Our lab instructor while opening a can of re-fried beans for a tutorial on stoma cleaning, "Yeah - we went there."

At Least I Can Nurse My Coffee...

2009-09-28T21:01:00.000-07:00

We started today at 8am with a "standardized patient" assessment. Standardized patient exams (SPE's) are a staple of this program in which actors feign symptoms and we practice nursing skills just as these skills would be applied in a hospital setting. Our clinical lab looks like...well, a clinic, replete with your typical clinic exam rooms.

This morning we assessed our actor patients for skin integrity, checking our fictional charges for bed sores or other skin degradation. SPE's have the unique benefit at training us to integrate our clinical skills with communication. While assessing the patient's skin, for instance, we were were gauging the patient's overall health and health risks through conversation as well as putting him at ease with an explanation of the care we intended to provide.

After our SPE, we headed back up to lecture for our "fundamental of nursing" midterm, which consisted of fill in the blank or multiple choice questions on the topics of hygiene, preventing patient falls (a huge issue for hospital staff), immobility of patients, nutrition and feeding, bladder and bowel systems, and injections. The test was straightforward, especially since most of the clinical interventions (urinary catheters, bowel and urinary diversions, fall risk assessments) we had already seen or used with patients in the hospital during the last several weeks.

A short lecture followed the test, then we headed out for lunch. Several of us grabbed a seat at the local coffee bar and conferred on our respective hospital experiences- stomas, non-compliance, polypharmacy, and patient comorbidities up the whazoo. We also reflected on our newly gained ability to discuss bodily fluids while drinking lattes and eating cottage cheese.

Concepts in Nursing lecture began at 2pm after lunch, and we discussed topics of culture, ethnicity and prejudices. Pharmacology began directly after that at 4pm and we really began to get into specific drug actions beginning with neuropharmacology. We had our weekly pharm quiz, lecture and discussion, followed by several students presentation of their assigned drugs. (Each student is responsible for committing all aspects of one drug to memory and sharing their information with the class.)

Several of us confided again - this time to admit to some feelings of overwhelm with this expedited curriculum. I admitted to shedding a few tears into my cupcake fondant this last Tuesday. The quick pace paired with the knowledge that messing up could really, honestly, genuinely injure another human being can be daunting.

We left a bit before 7pm, all giddy with mental exhaustion. After class I picked up some veggie chow mein, switched on some Gene Kelly Singin' in the Rain, watched a Michael Moore CNN interview, did a cathartic kitchen clean and celebrated memories of my now late puppy, Jordie.

Later this week: my first independent patient assignment at the hospital and bowel and bladder care in lab.

First Lectures of Fall Semester

2009-09-02T22:37:00.001-07:00

I started off the day with a hop in my step and all the vigor that comes with the first day of school. Though I think the coffee buzz wore off just about by 10am, with 7 more hours to go of lecture.

This semester we start with pharmacology, "fundamentals of nursing," and "conceptual bases of nursing." With my favorite professor at the helm, Conceptual Bases will have to be fantastic. She started out with the history and evolution of the nursing profession and many of the current challenges for future development. I was surprised to find that most nurses do not belong to the American Nurses Association (ANA), the accrediting agency for nurses and in many ways a conduit for solidarity and social impact. A possible cause discussed in class is the disparate nature of nursing - nurses come in with associate degrees, certifications, bachelors and masters and are all lumped into one body. I'm excited to be part of a profession that is in many ways still in the midst of its development; I feel like I can work with my colleagues to affect the direction of the profession and coordinate to increase the voice of the nurse population in advocating for patients.

The Pharmacology and Fundamentals courses were more the nit and grit of the schedule. Topics included bed positions, patient restraint guidelines, avoiding personal injury, caution and guidelines for administering meds, etc. Much of the information at this point was fairly straightforward, but we have a laundry list of reading assignments, podcasts and lab protocol texts that will certainly send us exponentially deeper into the material by next week.

I should be overwhelmed, but I'm too busy feeling giddy at the news of free flowing and free (costing) coffee at the grad lounge. It really is the simple things, especially after a long day.

We'll see how the Caffeine Motivation paradigm plays out over the course of the year...

Back to the Waiting Pool

2009-08-31T00:14:00.000-07:00

With the beginning of the fall semester beginning this coming week, I'll hopefully have more to share about the realities of nursing school. This last week was a bit of a wash, during which I mostly bummed around, baked a lot of sugary desserts, watched internet TV....etc. I guess it was also sort of a "wash" since I did a lot of house chores and laundry.... anyway...

The upcoming fall schedule will be one full day of lectures on campus, a second full day spent in the mock clinical lab on campus (complete with a mannequin that gives birth), and a final third day at a nearby hospital with 10 or so other students and a clinical instructor. I'm unclear about the play by play for that last day. The days are long - 12 hours or so- but I love the compression since it will allow me to arrange a full four days with other obligations or enjoyment.

This week has mostly been down time between the summer Health Assessment course and fall semester, but I've confirmed one important fact about a nursing education: Nursing textbooks and supplies are expensive. I had been told as much, but I wasn't about to believe it until I literally bought it.

The eBook situation is still in some sort of alpha version limbo, so we were encouraged to buy the hard copies this semester. The books came out to roughly $430, along with a lab bag for $120 or so, the mandatory iPod Touch (along with drug references software) which came to $440 or so. Lab coat, scrubs, notarized ID tags, Stethanie, and pressure cuff - I think tallied around $175. All in all well over a G in nursing schwag.

The cost breakdown provided by the school estimated a year worth of books and supplies would exceed 4K. The kicker is that much of the supplies are needed prior to the loan disbursement date, so I would advise anyone starting a program to save up. Were I to do it over, I also might have requested a list of the texts that would be needed well before the semester was beginning so I could shop around.

Still, the long term financial cost benefit ratio comes out well in my favor. And since I don't always trust my own mathematics, I was pleased to hear several fellow MEPNers come to the same bottom line. The educational costs, hefty as they may seem, still lead to a significant pay increase from the average college grad income. And there is the priceless amenity of working in a fulfilling, albeit demanding, career. So if nursing is what you want to do, don't sweat the investment.

As an added plus, the down time also afforded us MEPNers some time to socialize. This meant a margarita night with those further on the in the program, and time with my clinical site fellows and lab partner. I have yet to meet anyone who I don't both enjoy and admire, which is perhaps more motivation than any tuition/salary calculations could afford.

Is it fall already?

2009-08-11T22:18:00.000-07:00

Hemos llegado!

Nous sommes arrivés!

我们已经来到！
We've arrived?

This past 168 hours has been a blur of body parts, lighted tools for inspecting body parts, lectures, library/ i-Pod tours, and lengthy explanations that inevitably end with, "But don't worry, we'll cover that in your advanced courses."

I spent a half-conscious half hour this morning trying to decide if I should wash my hands before or after greeting and shaking hands with a new patient. (I found talking while washing to be highly awkward.)

In short, the faculty are outstanding and highly helpful. No one has been too busy to answer the stream of administrative questions from the students. The tone from the class is that we'll make our way through the brambles together and arise victorious at the other end. (Case in point: Both a faculty and student spent a few extra minutes after a tiring day of exams helping me find my misplaced sphygmomanometer.)

Of course, no journey would be complete without a trusted confidante. With that, meet Stethanie...Humble though she is, without her I might not have survived the HEENT exam this afternoon. Without her, I would not have intimate knowledge of my own breath sounds, nor would I be equipped to lasso passersby to cuff them and extract BP readings before releasing them back into their natural behaviours and environments.

This week, everything below the "HEENT."

E-gads!

2009-06-30T20:01:00.000-07:00

I move to San Diego this weekend.

Christine Murphy is the most amazing woman on this planet, and happily, the new Consulting Assistant at my workplace.

I have a new best friend in the San Diego area - Kafka.

I need ciel-blue scrubs, mal-practice insurance, a dolly, an i-touch, a skype account, and perhaps a good book and a glass of good wine.

This was a pitiful blog entry and I will do better next time...

Finding a Replacement

2009-05-17T09:31:00.000-07:00

As of July 15th or so, I'll be moving to San Diego to begin my MSN program. Of course, this large change means I have a lot of loose ends to tie up before I'm ready to start the program:

1. Find a replacement for myself at work.
2. End off my studio lease here.
3. Find convenient and cat-friendly housing in SD.
4. Get my health exam, a host of vaccinations, drug/background screening, sign away rights to my first born child...

I've been particularly concerned over finding a good replacement at work and ensuring a nice smooth transition with the clients. I've been bringing it up each week in office meetings. After discussing the desirable qualifications and characteristics on Friday, we were finally ready to begin posting job ads this coming Monday.

As it turns out, the hiring process started even sooner. I walked into work today (Sunday) to pick up a file. Posted on the door to the office was a note for me from George, the Head Consultant/Owner/Boss Extraordinaire of Expansion Ventures, Inc. It read:

Jes,

I met a guy named Ted over the weekend. He seems like he might be a good candidate as your replacement.

I told him to come over on Monday for an interview with you and to bring a resume.

I gave him a key so he might be waiting to see you this morning.

Let me know what you think?

G.

I was intrigued. What would have led George to offer an interview candidate a key to the office, just so he could be there first thing Monday? Where did they meet? Perhaps the guy is on a tight work schedule and needs to interview just as soon as I come in? And would this Ted fellow not be intimidated that there was a note about him on the door that I might not have intercepted first?

I unlock the door and step into my office. Inside is a teddy bear the size of an ACTUAL bear (assuming real bears have giant chipmunk cheeks), sitting at my desk, holding a paper in his puffy paw. I was perplexed until I saw that the paper was in resume format. My next thought was, "Wow, this Ted guy is nuts to have left his resume with a giant bear! He must really be interested in the position!"

I looked more closely at the resume and figured it out...

Resume
Ted E. Bear
(Most people just call me "Teddy")

Qualities

1. I'm a good listener.
2. I'm always there for the clients.
3. I'm warm and approachable.
4. I'm always friendly.
5. I'm willing to learn.
6. I never talk back to the boss.
7. I have a big head for facts.
8. I'm very moldable into any position.
9. I like people and people like me.

...

Human Ted was a ruse!

I'll really miss George and everyone I've worked with these last three and a half years. My (non-stuffed) replacement will enjoy a great group, as supportive and creative as they are exceptional in what they do.

Good Sunday

2009-04-12T20:03:00.000-07:00

My dad came out of the hospital today! Happy Easter, indeed. =D

And since I will soon lose hospital photography rights (nurses can't record or photograph...not that I would save for adorable family moments...), I felt especially compelled to document my dad and Dot's set up yesterday. It's a sparsely known fact that hospital patients double as excellent lounge chairs.

Caffeine Perks

2009-04-09T22:56:00.000-07:00

Oh, Coffee. What can't you do for me?

I was sitting with my dad in pre-op at 8am this morning, waiting for him to go in for his brain surgery to once again remove this incorrigible xanthoma. I pulled down the sleeve of my Starbucks latte in search of extra reading materials (after two hospital stays in as many years, you'd think I'd learn to bring my book). Here's what I found:

The irony of commitment is that it's deeply liberating in work, in play, in love. The act frees you of the tyranny of your internal critic, from the fear that likes to dress itself up and parade around as rational hesitation. To commit is to remove your head as the barrier to your life.

The last few weeks have been full of life changing moments. I have always embraced responsibility but somewhat shirked decisions that will last for the long haul, I think for fear that as my character changes over time I'll no longer be able to live up to them. I think I needed a reminder of this opposing perspective; that to commit yourself to something allows you greater potential for personal growth. Without it, perhaps my growth is meandering and non-linear... and indeed more confining and limiting than had I created a path from the outset.

Quotations aside, the greatest discovery of the day was to learn that my dad's surgery was a success.

Meet Your Fellow Applicants

2009-03-07T16:06:00.000-08:00

Participating in a group interview for an entry-MSN program, I got a sampling of some of the characteristics of the interviewees. If these are nurses, then I've made the right career decision...

1. Compassionate and Gregarious
The interview included a tour of the lab, which required a 5-minute bus ride to the facility. It may as well have been a bus to summer camp. Within a minute, the bus was abuzz with laughter and chatter. Within 2 minutes, the din was overwhelming and the driver laughed and shook her head at the sight of us. We might have been competitive and cold given the circumstance. Instead, we had become a united front and had several new friends.

I almost expected that some of the admitted applicants might have forfeited their spot out of their warmth and camaraderie, "Oh, you just have such promise. Please take it, I'll just sell this new house, pull my kids from school again, move back east and apply next year. Don't forget to write!"

2. Only Mostly Women
Of the 108 interviewees, I see maybe 16 men on the roster. I expect this ratio to grow now that nurses no longer wear the silly little white hats and skirts.

3. "Nursish" Background
I didn't meet any new grad theater majors. Well, rather I should say that if they had been theater majors that their most recent occupation was more geared towards medicine/research/nursing/emergency care.

I met:
A firefighter
An ex-medical student
A nurse's assistant
A few EMT's
A research assistant
A community health center staff person
A few recent college graduates, backgrounds in Biology, and I think one in Psychology

I think the idea being that none of these candidates applied on a whim. They showed some predisposition for nursing and patient care besides completion of the pre-requisite courses.

Timelines

2009-03-07T15:31:00.001-08:00

I chose to apply to eight nursing programs. This was on the advice of my high school counselor as I was applying to under-grad, "You always need a backup - and a backup backup". I was advised to apply to one hard-to-reach program, several more moderate choices, and one that would readily accept me on account of English literacy and lack of a lengthy prison record.

My nursing applications proved more complex, however, as my fellow entry-level MSN applicants arise from nebulous and disparate clouds of promise. I have no clue who these people are!, whereas for undergrad most colleges posted a dossier on the average admitted student, practically down to their shoe-size. I heard during several entry-MSN information sessions that experience in the medical or research fields is helpful, yet also heard that theater students tend to make outstanding nurses. So I applied to eight programs.

What I had forgotten about admissions, however, is that schools want a response within a week or two of acceptance. This proves difficult when these eight schools send letters of admission anywhere between November to April. So do I put down a non-refundable deposit on a school I think I may sort of, probably, maybe want to attend?

U.S. News and World Report

2009-01-15T22:21:00.000-08:00

US News and World Report offered their 2009 graduate nursing program rankings online. I pulled off those in or near California. The ranking is listed on the left hand side, score to the right.

U of W and UCSF go back and forth for the top ranking. We Californians are lucky to have many great programs nearby. We also have both larger public and smaller private universities, which cater to different student needs.

My experience at UCSD, which is very large, has left me wanting a smaller private university for graduate study. At schools like University of San Diego and San Francisco, the student to professor ratio is somewhere around 8-20: 1. Of course, the downside to this is higher tuition.

1	University of Washington Seattle, WA	Score 4.7
2	University of California--San Francisco San Francisco, CA	Score 4.6
7	Oregon Health and Science University Portland, OR	Score 4.2
12	University of California--Los Angeles Los Angeles, CA	Score 4.1

26	University of Arizona Tucson, AZ	Score 3.8
32	Arizona State University Phoenix, AZ	Score 3.7
47	University of San Diego San Diego, CA	Score 3.5

54	University of San Francisco San Francisco, CA			Score 3.4
72	California State University--Los Angeles Los Angeles, CA			Score 3.2

95	University of New Mexico Albuquerque, NM	Score 3.1
115	San Francisco State University San Francisco, CA	Score 3.0
115	Seattle University Seattle, WA	Score 3.0

141	Samuel Merritt College Oakland, CA			Score 2.9
167	Azusa Pacific University Azusa, CA			Score 2.8

167	Mount St. Mary's College Los Angeles, CA	Score 2.8
167	San Jose State University San Jose, CA	Score 2.8
167	Seattle Pacific University Seattle, WA	Score 2.8
167	Sonoma State University Rohnert Park, CA	Score 2.8

203	California State University--Long Beach Long Beach, CA			Score 2.7
203	Northern Arizona University Flagstaff, AZ			Score 2.7

** I only posted from the top 200 rankings.

Fun in Engineering

2009-01-14T22:29:00.000-08:00

In a related field of interest (ok, completely unrelated), an anonymous source brings us the latest to come from the engineering minds at JPL. Apparently grants are bestowed to the engineers who best ally their project with a (related or unrelated) topic of public concern. Bonus points if you employ jazzy acronyms, allusions to propitious figures, full use of the PowerPoint image cache, and a 'mission accomplished' thumbs up.

Securities

2009-01-09T21:15:00.000-08:00

A funny thing happened on the way to San Francisco.

After saving myself the $50 it would have taken to check my baggage, I lumbered toward the security check line with my archaic, non-wheeled ex-bowling bag in tow. As the general passenger line grew, they sent a section of us over to the shorter first- class line to keep things moving.

After 15 minutes of shuffling and chit-chat, a snag. The guards shut down the first security line altogether but instead of sending the newcomers to the end of the first class line, they just shunted them into the middle. Suddenly, me and my chit-chat buddies were behind everyone who arrived at security after us.

Those nearest me, experiencing this little injustice, represented a nice cross-section of society. There was the 60-something executive, dressed to the nines. The family headed on vacation. A young couple. A businessman. A few single passengers. And I think what happened next is a perfect model of how the world works.

My dearest chit-chat buddy and I sniggered sarcastically at the 'wonders of bureaucracy'. The businessman complained a little to the guard, who blamed it on the other guard (who was conveniently just out of earshot). And while each of us was so engaged, the executive silently slipped out of line, past us all, and through security without a word or a hitch. The other businessman was emboldened by this model of action, and asked those of us just in front of him if he could sneak past, since he was late for his flight. No one argued.

So when the system fails, it's those who most expect they belong at the front who comprise 'the front'. And they aren't taking anyone with them. Yick.

Presidential Options

2008-10-25T22:03:00.000-07:00

Obama 2009!

The following provides some great information on Obama's plan to reduce the nursing shortage by ensuring a secure and fair work environment and providing financial incentives for nursing students. It also details other aspects of his universal health care initiative:
American Nurses Association Q&A

Applying Myself

2008-10-25T21:13:00.000-07:00

What a month! The holiday season will soon be upon us. The presidential election steadily approaches. The very premise of capitalism has been undermined with our flailing stock market.

And in my personal world, I have an incoming tidal wave of consulting work and medical website text (consulting and website work appear to be inversely related to national economic vitality).

During the evenings and weekends, I am jitterily working on my nursing applications (it's the coffee). Several down, several to go. Outside this, I'm in speech class which has proved enjoyable. As with applications, I have 2 speeches down and two more to go (so far my topics have included 'A Blood Cell During CPR' and 'Physician-Assisted Suicide'- can you tell I'm obsessed with all things health-related?).

If you are looking to take your pre-requisites, I recommend enrolling at a community college rather than a university extension program. The classes are more diverse, so you get a free helping of life experience and social enrichment for your bargain-basement tuition. My new peers include Frankie, a forty-something Hispanic grandfather of two. He delivered an eloquent speech on the speculative and proven reasons that nations go to war and another on his concerns at a proposal to lower the drinking age to 18. He is a war veteran and ex-drug addict, yet for these harsh experiences he is optimistic and pursing his college degree in some health-related field. He greets me more cheerily than I typically hear from anyone else throughout my day.

Then there's Michael, an 18-year-old who each night laments the control his parents exert over his life. My responses have been a reminder to me that I am growing older - I find it difficult to relate, and always digress into the old 'I'm sure they mean well' routine, to which I get a look that I'm sure his parents know well. His speeches have included, 'Why Wrestling is the Best Sport' and 'How to Care for Your Toyota Pick-Up'.

My other life-enrichment routine has been perusing NP blogs. These serve as my motivation to keep working diligently on the apps.

*Note to self - look further into Epocrates drug interaction software.

Dear Dr. Herriot

2008-08-12T21:04:00.000-07:00

Nope, this blog has nothing at all to do with veterinarian work, for those of you familiar with James Herriot. I read many of his books as I was growing up, staying up late, enthralled with his accounts of working in the English countryside as a large animal vet. His anecdotes were by all accounts true to his experience, and reflected his growing knowledge on both the biological and emotional elements of caring for health.

My journey should prove likewise wrought with emotion, I'm certain, filled with daily epiphanies, I'm sure, and jam packed with clinical and class work, I'm told. I'm laying this down earlier in the game than Dr. Herriot. This last year, I have been placing little check marks, semester by semester, next to the pre-requisites to entry level master's programs in nursing. I'll have completed these in the next several months, along with my applications to several programs of choice.

Recount of Pre-Req Work:

Fall, 2007:
Medical Terminology at Pasadena City College (PCC) - interest, rather than pre-req, but the nurse instructor helped to inspire me toward an MEPN

Spring, 2008 (all at PCC):
Anatomy 25
Microbiology 2
Psychology 1 (why cognitive science didn't fulfill this req, I will never know)
Sociology 1

Summer, 2008 (all at UCLA Extension):
Physiology - Physiological Science XL3
Nutrition - Physiological Science x451

Next, I am enrolled in Speech 1 and Lifespan Psychology at PCC for Fall. Then Winter will be tentatively be Epidemiology, if offered at CSUN or Cal State LA. Otherwise, it may be Chemistry, with an organic chemistry component, and English Composition.

This blog will mainly be an account of academic pursuits, and perhaps lead into an account of my experiences in the world of advanced nursing. To mix things up I'm certain there will be plenty of asides.

I welcome your comments, and hope that this can be a helpful tool for your own professional pursuits, for you aspiring NPs out there.

Cheers.