Up In The Air

Life is up in the air right now.

I have no real focus, and I'm really unsure what direction to proceed.

My original plan was painfully simple. Go to nursing school. (Check.) Graduate and get a job on the biggest, baddest ICU around. (Check.) In two or three years apply for CRNA school and get on with life. (.....)

Muddying circumstance #1:

This lovely president of ours, Obama, enacted legislation that dictates those that make 10 years of payments on their federal student loans while working in a public service capacity, will have the remaining balance of their federal student loans forgiven. RN's definitely qualify as long as they work for a not-for-profit organization, which I currently do. Interesting tidbit: Nurse Practitioner's qualify, CRNA's do not. After doing the math, this loan forgiveness could total as much as $200,000 in my case... Market analysis of compensation for NPs shows that the gap between CRNAs and NPs is starting to narrow. In short NPs may soon be making the kind of salary reserved previously for CRNAs.

Now consider that the cost of the CRNA schools in my metro area both top $75,000, while NP school falls under the category of regular graduate school. CRNA students are prohibited from working during school (in fact both schools here will kick you out of the program, no questions asked, if they catch you working.) NP students at local schools do not have any such restrictions. And here's the kicker--the tuition reimbursement program at my current hospital *almost* covers the tuition for graduate school. They also have a TDA (Two Day Alternative) program where employees work Saturday-Sunday every week--two shifts, but keep full time status and benefits, and earn an extra differential that approximates working three shifts instead of two--that would allow me to go to school full time during the week.

The nursing school I graduated from has an Acute Care Nurse Practitioner program...

Thinks that make you go hmmm.

Muddying circumstance #2:

My wife and I have been fortunate enough to have her younger sister living with us to watch our kids while both of us work night shift. This allows us to work as many shifts together as possible, allowing us to have days off together. However, that situation will be changing. I'll spare you all the drama and gnashing of teeth, but rest assured it hasn't been a pleasant situation with frustrations ranging from not being available when we were counting on her, to wondering about our kids safety while in her care.

The nice thing about working as nurses is that we only work 3 days a week, so it *can* be done not needing childcare at all. But that means that we will only have one day a week off together, and really because of the logistics of night shift, it means that we'll have two half days off rather than a full day.

We are exploring options that include me moving to day shift to cut down on the daycare needs, but that also requires me transferring to another hospital within the system since my wife and I work on opposite ends of the city currently. And that means leaving my beloved CVICU...

Muddying circumstance #3:

I have been dying to get out of this town since I got here (state, really). The summer heat/humidity kills me. I crave seasons. I crave snow. I crave being able to spend time outdoors without melting into a puddle on the blistering concrete or triple digit asphalt.

I began researching grad schools in other parts of the country, and have been very, very attracted to Duke. I love the idea of a big name school. I love that the hospital is next door to the school. I love that the hospital has a program for employees that pays up to 90% of your schooling in exchange for contract on graduation... I love the idea of North Carolina, where the average high temperature in the summer tops out in the low 90s... I love that North Carolina is a Nurse Licensure Compact state... I love that Duke has one of the few Pediatric Acute Care Nurse Practitioner programs in the country...

Aauugggh! My brain hurts!

The Great Laude Wars

One of the things I've been looking forward to the most about graduation has been Latin honors. I've always been more than capable of excelling academically, I just never really cared to. The effort required to track every grade percentage point just hasn't seemed worth it to me in the past.

For example, of my high school class of more than 800 students I graduated only at #24, all the while tutoring both the valedictorian and salutatorian in math and physics. If I'd only taken the trouble to turn everything in, I'd have easily challenged them both for their positions.

To me though, it was much easier to rock the evaluation exams than to do the day to day drudgery of homework and coursework. Hence my 36/36 perfect score on the ACT when I took it my senior year in high school. The trend continued when I got into college. The exams that blew everyone else away, I was that person that blew the curve for everyone. I consistently performed at high B/low A level, regardless of the difficulty of the exam. I lost points not for lack of knowledge or understanding of concepts, but rather for housekeeping details that I just didn't bother to read or attend class to hear. This style of ill-preparation and poor class attendance earned me a stellar 3.2 GPA in my first undergraduate degree.

When I graduated with my BS in Biology, I decided I wanted to go to medical school. Clearly a 3.2 GPA wasn't going to get me noticed by any medical school in the continental US, so I knew I'd have to rock the MCAT to even have a chance. That was probably the most legit exam I've ever taken, and I only scored a 29 the first time out. A decent score, but hardly earth-shattering especially combined with my crappy GPA. I buckled down, actually studied, and scored a 38. That score generated some interest from the schools, but I ultimately decided against going to medical school.

So when I came to nursing school, I made a decision from the outset that I was going to do the work. If I was going to take this second chance, I was going to do it right.

And so I did.

I kept track of every little percentage point. I obsessed over assignments. I studied for exams I knew I could pass without trying in search of those extra 8-10 points. I had a few bumps in the road, like when my son was born at 11:20 pm the night before my pharmacology final, and I got less than 2 hours of sleep. The final dropped most people a letter grade it was so ridiculously hard, and I was no exception. I ended up with a B. Then there was the research teacher that decided I was Satan's spawn and through the subjective grading of research analysis papers, orchestrated me receiving a B by less that 0.02 points. I talked it over with my wife, and we decided I wouldn't grant the instructor the satisfaction of seeing me worked up over it, so I let it go without challenging it. In the end I have a 3.88 GPA for nursing school, and achievement I'm quite proud of.

Imagine my surprise when I found out I would not be graduating with Latin honors. You see, when I entered nursing school, they automatically upgraded the catalog under which I would be taking classes, regardless of the catalog under which I first entered the university. They also updated the requirements for Latin honors. Previously it had been either an overall GPA over 3.5, or the last 45 hours over a 3.5. The new requirements require both an overall GPA greater than 3.5, and the last 45 hours over a 3.5. Not only that, they would calculate overall GPA from every hour ever taken at the university, not just the hours applied toward the current degree.

And so that 3.2 overall came back around to haunt me. Clearly my own fault, but people change. And I have dramatically.

If only the hours being used for the current degree were calculated, I easily had the >3.5 overall required. And my last 45 were way above requirement. Additionally, if I had transferred in to attend nursing school from an outside university, all that GPA would be wiped clean--lost in transfer credit hours. So because I chose to be loyal to university, I get penalized.

I decided that being a nurse was all about being an advocate, and I was going to start by advocating for myself. I made an appointment with the assistant registrar/graduation counselor. She refused to consider my points, and was actually quite rude. So I made an appointment with her boss, and in the meantime wrote the following email to the deans of my nursing school:

Dear Dean HeadHoncho & Dean FirstAssistant:

When I first came to ### in the Fall of 1998 in pursuit of my first Bachelor's degree, I was young and unfocused. It showed in my grades--yet still I managed to eke out a 3.2 overall GPA when I graduated with a BS in Biology in 2001. Nine years later as I am about to graduate ###CON's BSN program, I am older, more mature, and much more focused. As a result, at the end of this semester I will have over a 3.8 over the last 45 hours--the criteria used to award Latin honors. Mind you, I did this with a job, 3 children, no daycare and wife that works full time nights as a nurse.

Unfortunately due to arbitrarily having my catalog year reassigned when I entered the nursing program, my overall GPA doesn't qualify me for Latin honors. However, if I had done my prior coursework at another college, those hours would not count toward my overall GPA, and I would easily qualify for Latin honors. This seems a bit unfair to me, and rather unfortunate. Because I chose to stay loyal to ###, I am being penalized by not receiving Latin honors.

I came to nursing school for the sole purpose of gaining my BSN so I could continue on to grad school. I would love to stay in the ###CON program, however since my undergraduate overall GPA will continue to haunt me, I just don't see that as a possibility any longer. I refuse to patronize a learning institution that endorses a double standard for its students, refuses to reward students for institutional loyalty, and arbitrarily changes the rules as it deems convenient.

I know that you have no direct control over who receives Latin honors, but I thought you should be aware of the fact that you will be losing at least one well-qualified student from the pool of potential graduate students. NP? DNP? PhD? Who knows how far I would have gone. I feel you also should be aware that people like me, loyal to ###, are being treated differently than someone who hasn't worked any harder than me, but will be rewarded for disguising their overall GPA in transfer classes.

I'd be happy to entertain your thoughts on the situation. I am currently working the chain of command to try and resolve the issue on my own--now making an appointment with HeadHoncho Registrar.

Regards,

NurseXY

Something I said must have lit a fire somewhere, because by the time I attended my appointment with the registrar the next morning, the Dean had already written an email forwarding my email on to him. Oddly enough, they found it appropriate to return me to my original catalog year (which never should have been changed), and suddenly I qualify for Latin honors. Magna cum laude in fact.

However, as the assistant registrar/graduation counselor rather gleefully told me, it doesn't matter because the programs have already gone to print so it can't be changed to reflect my honors.

But it matters to me.

And it will matter on my CRNA school applications.

I had purchased honors cords when I bought my cap & gown a couple of months ago. And you can bet your tassel I'm going to wear them during graduation.

Level II Interview

I got a call today to schedule a peer interview with the CVICU at the Level II trauma center across the street from my wife's hospital. I had heard the rumor that they weren't going to be interviewing until November some time, so I was delighted to hear from them. I go in at 1330 on Thursday to meet with a panel of staff nurses, and then they will make recommendation to the managers and charge nurses. Then the managers and charge nurses conduct a second round of interviews to decide on who gets the offer. Kind of stressful really, so I think I'll just concentrate on one step at a time.

Good things about this hospital include the fact that it is across the street from where my wife works. This means we could carpool, and even eat meals together. It is also a unit with a reputation for turning out CRNA school candidates. And better yet, many of the staff from the schools work at the local CRNA programs--including on the admissions committees--work at this hospital also. It is also a much shorter drive than driving to Gargantuan hospital where I've also interviewed. Like half the time and distance.

On the downside, the parent organization for this hospital has a reputation for being super cost conscious. I did my critical care rotation on this unit, so I have a pretty good picture of day to day life there. There are often several triples at the beginning of the shift. They usually get them shipped out pretty quickly, but the workload is definitely legit.

If I get an offer from both the Level II hospital and the Gargantuan hospital it will be very, very tough to decide.

As always, I'll covet your good vibes and prayers on Thursday. I've heard these peer interviews can be tough.

Pressure Cooker

I've been open and up front with my boss about putting applications in at other hospitals. He's cool with it, and just wants me to end up somewhere I can be happy. Which I guess is much better than the alternative.

However, I went into work to write my schedule in, and he called me into his office. He let me know he would be posting the internship position soon, and should he decide to extend me a job offer, I'll have a hard deadline to give him a decision.

I can certainly understand his position, he needs to get a candidate tied into the internship. My fear is simply this, if his deadline falls before I hear back from the other hospitals, what do I do?

Do I take the job? Because an ICU job of any kind is nothing to throw away lightly, especially given my CRNA school plans.

Do I pass on the job? Wand just hope and pray the other, better positions come through? What if I pass and then I don't get hired into my dream job?

Even thinking about this quandary has me throwing a string of PVCs. The pressure is mounting, and he hasn't even given me a deadline yet.

Thoughts anyone?

Networking

My wife and I attend a good sized church--about 10,000 members. It's big enough that we felt a little lost for awhile, and were torn about attending there at all. That is, until we got connected with a small group, and that made all the difference. But that's another post.

It turns out that our small group is led by the facilities director at the church, so we're often privy to a behind-the-curtain glimpse of what's going on. Considering the number of people on the church campus every Sunday, my friend decided it might be a good idea to have an emergency medical response team put together. In the process of recruiting volunteers for this team, he met a CRNA. Of course my friend mentioned that I was hoping to go to CRNA school in a few years, and the CRNA asked him to give me his email address.

I emailed the guy, we exchanged phone numbers, and I finally got to talk to him on Monday.

He spent about 30 minutes on the phone with me, answering all my questions about CRNA school, the CRNA job market, where he thinks the future for CRNAs will go, etc. Back when I was contemplating medical school, one of the biggest reasons I let go of that dream was the responses I got to the question I put to most of the physicians I'd interact with: "If you had it to do all over again, would you still choose to go to medical school?" Rarely did I get a physician tell me, "Yes, absolutely." And when they would say yes, it was always with qualifications or reservations. Mr. CRNA answered unequivocally that yes he'd do it again, no reservations. He loves his job.

I cannot even begin to tell you how much peace of mind this gives me. This is a running theme I've noticed with nearly every CRNA I've met. They're funny, engaging people that are a blast to be around. My guess is that it's because they're HAPPY. Nurse friends, tell me how many docs that you interact with, you can just tell they're HAPPY.

Anyway, back to the story. It turns out Mr. CRNA is not only a CRNA, but he owns a private practice that staffs two day surgery centers. But more than that, he is also a regular lecturer, at the school I want to attend. With. friends. on. the. admission. committee.

I have never met the guy, but he has already told me that if I do the work to get an interview (grades, work experience, GRE score) he'll sit down with me and help prepare me with actual questions the committee might will ask me. Then if he feels good about that, he'll call his admissions committee friends and drop my name.

Oh, and he wants to get together for lunch in the meantime.

God is good.

PS: No word from the externship hospital, yes, or no. Beginning to wonder if it was an organization I actually want to be a part of in the first place.