From the Beginning: Interview

Since my posts here have become a little sparse, I thought this might be a good time to consolidate my nursing school posts from an older blog. Here's a post about my nursing school interview, originally posted September 25, 2008:

My interview went well today. I only managed to tongue tie myself once. My interviewer's office phone went off 3 or 4 times, her personal cell phone went off once, and someone knocked at the door and intruded. Interesting.

The questions were pretty basic:

Why do you want to be a nurse?
What are some qualities of a good nurse?
What are your strengths that you would bring to nursing school?
What are your weaknesses that you would bring to nursing school?
How do you study?
How do you plan to deal with the rigors of the program?
Do you plan to work?
Think of a time when you had a great deal of stress. How did you deal with that stress?

The one that made me think was:

Think of a time that a problem couldn't be solved with your current way of thinking. What did you do to solve the problem?

All in all it was a relatively painless experience. She seemed genuinely attentive, and took notes on my answers. When we were through she all but told me I'd gotten in. Acceptance letters go out towards the end of October, so I'll be glad when it's in my grimy little hand. Orientation is Jan 7 and 8, but classes don't start until after the 20th. Nice little break there to get myself properly immunized.

Oh boy.

Solo, and not the big red plastic cups.

Tonight is my first solo shift.

NurseXY RN-BSN.

No more "Let me ask your nurse...", "Let me ask my preceptor...", "What do I do now..."

Just me and my paper brain. I'm probably making a bigger deal out of this than it really is. My coworkers are really great about helping, and I haven't met any of them that I feel I couldn't ask to help me. I have been essentially on my own for a few weeks now, even with a preceptor. Multiple times my preceptor got called away to take patients of their own, so it's not like it's my first time solo.

Still, it's different.

There is an excellent chance I will get floated tonight, or even left at home on call because coming off orientation puts me right at the top of the "bad list". Both of my fellow ex-interns floated their first night off orientation. They both said that it was simply boring being off our unit. At least I don't have to worry about a step up in acuity, haha. And the nice thing is we can only be floated to other ICUs, no floors.

My first shaky day of clinical (during which I participated in a code, got to put in a flexiseal, put in a foley, and started an IV--we were only supposed to observe, haha!) seems like a long time ago, mostly because it was way back in 2009. Not to mention the hurdles I've crawled over, ducked under, or simply lowered my head and obliterated since then.

I'd wax nostalgic, but I really need to get some lunch and then take a nap before my night shift.

Thanks for reading about my journey and offering bits of advice and encouragement along the way. It means a great deal to me.

Special shout out to Kirsten, Tiffany, and Running Wildly for being with me from the bitter beginning--probably couldn't have made it without you!

From the Beginning: Busy Day Tomorrow

Since my posts here have become a little sparse, I thought this might be a good time to consolidate my nursing school posts from an older blog. Here's a post about prerequisite classes, originally posted September 24, 2008:

I have a busy day tomorrow... Start things off with an Anatomy & Physiology exam at 9:30, but I'll be up at school long before then, studying. I think having a Bachelor's in Human Anatomy is actually spurring me to study harder. I'm deathly afraid that I'm going to slack off, thinking I can coast on my prior knowledge, and I'm going to get smacked. How embarrassing would that be? Failing an undergraduate anatomy exam would just top off my whole chiropractic school experience. I should be fine, there isn't much material covered, and I am comfortable with the material. Still though, when one gets complacent...

Then I have class until 1400. At that point I head home in time for my girls to get home from school.

Then out the door again at 1630, all spiffed up--suit and tie. My nursing school interview is at 1730. It's an exciting step in my journey, and I hope I'll sleep tonight. I am scheduled to interview with the Assistant Dean, the one in charge of admissions--no pressure, haha! The interview is scheduled for 30 minutes, and my classmates that have already interviewed said to expect to be there for every minute of it. As long as I don't fark up my interview, my advisor has all but said I'm a shoo in. I hope that holds true, and I really hope I don't fark up my interview! We'll find out officially by the end of October. Hopefully the mail moves a little more quickly than it did with my interview letter--it took a full week to travel less than 10 miles, within the same city.

I've been thinking about what I'd like to do once I'm through with nursing school. I'm almost certain that I could be just fine working as an RN in a critical care unit somewhere, hopefully a pediatric critical care unit. I've considered the thought of working on a transport team. How fun would that be? Travel, and nursing. Not to mention all the autonomy being in transit affords.

I have also thought about continuing on a bit. I could see myself as a Nurse Practitioner working on a critical care unit. The salary increase isn't very substantial over working as an RN though. Another thought is becoming a CRNA. Big time salary potential there and that's not something to blow off...

I'm sure the path I'm supposed to take will be revealed at some point. Let's hope sooner than later!

From the Beginning: Chest Pains

Since my posts here have become a little sparse, I thought this might be a good time to consolidate my nursing school posts from an older blog. Here's a post about interview letters, originally posted September 13, 2008:

This is the start of a new blog, and I'll update with back story as we get further along. But for now, I'd just like to get a post on the books.

Wednesday in my nursing concepts course, the Dean of the nursing school dropped by. She was there to relay information that the nursing school has changed their application process, and instead of submitting a writing sample, the HESI A2 exam would be used to assess verbal and written communication skills. This wasn't news to me as I'd already taken the HESI as a part of my application process for Spring 2009. The exam did not prove strenuous and thankfully I scored very well. Apparently however, there were 4 applicants for the Spring 2009 class that did not take the exam during the appointed times, and thus their application was incomplete. Since ours is the first applying class to use the HESI, the nursing school has made arrangements to allow those 4 students to take the exam anyway, though the deadlines are past. I'm not sure I agree with that--the nursing school did send two letters and numerous emails about the HESI, but I suppose compassion is the best policy. Especially if I were one of the 4.

Anyway, during her 5 minute spiel, the Dean mentioned that interview letters for the Spring 2009 applying class had been mailed two days earlier, on Monday. Sitting in my seat, I got goosebumps. I knew that this could very well mean that if I were selected for an interview, my letter was probably sitting in our mailbox at that very moment. I had to strongly resist the urge to gather my things and slip out.

Alas, when I arrived home, there was no letter in my mailbox.

Now, for perspective, I live about 10 miles from school, in the same town. Mail usually travels within the city in one day. Mailed on Monday would have a strong possibility of being delivered on Tuesday, and almost positively by Wednesday. Stretching to Thursday was unusual, but not beyond the scope of imagination.

Thursday afternoon the mail arrived. No letter.

At this point I was getting concerned. My conversations with my advisor, and even the Dean, had led me to believe that I had a very strong chance of being accepted to the program, but I was beginning to have doubts.

On Friday, I made a special stop at the house to check the mail between a business lunch and my anatomy lab.

No letter.

Now I was relatively certain that a letter was not mailed to me on Monday, and the panic began to set in. My hands were shaking, my mind was reeling, and I honestly had chest pains. I'm not sure if that's how anxiety attacks feel, but I do know that I was not in a happy place as visions of our carefully laid plans came crashing down around me.

I knew that if I let things ride, I would be a wreck all weekend long. I needed action. I needed answers. As I drove my way to campus, I dialed 411 for the number to the nursing school and called to make an appointment with my advisor. Luckily she had an availability, even late on a Friday afternoon. Meanwhile, I numbly sat through anatomy lab, making small talk to my lab partners, and making all the incisions in our fetal pig for our group. (It's amazing what two trimesters spent dissecting a human cadaver for gross anatomy will give you tolerance for...or callousness to?)

As my advisor walked me back to her office, she asked how she could help. I tried very hard to remain completely calm and affable, and I think I did a pretty good job. I told her I was curious about my application, as I knew that the interview letters had been sent out, and I hadn't yet received one. In fact I was wondering how I might strengthen my application so that next semester I might be selected to move on in the application process.

She frowned at me and said, "But we mailed your letter just yesterday."

It turns out that since I have a professional degree already, I'm in a different applicant group than normal undergraduate applicants. My group's letters hadn't gone out until Thursday.

I'm certain my spontaneous relief was transparently obvious to her, because she apologized for having stressed me out so badly. She then made a copy of the letter from the duplicate in my file so I could bring it home with me.

All's well that ends well, right?

Well, one would hope, but now the system won't accept my login name to schedule my interview...

37 Minutes Flat

Took a little quiz this morning. You may have heard of it...called the NCLEX.

I tried my best to not have any trepidation since it's a standardized exam, and given my track record with the HESI. I have to say though, I did get a little anxious. Probably a good thing given the ramifications.

I got to the test center about 30 minutes early--thank goodness for zero traffic on a Saturday--and there was already a line of people at the door. I pulled number 5 though when we were let in because I was observant enough to read the sign that said "Take a Number Please".

When called to the desk I presented my passport, my drivers license, and my ATT. I got photographed, fingerprinted, and palm-vein-printed. I stowed my things in a locker, subjected to a hoodie-hood search, and then was escorted to a test cubicle. I sat down, stuffed the earplugs in, and took a deep breath. Short tutorial, and then there it was, Question #1.

I forced myself to read slowly and deliberately, focusing on not rushing. Question #2 was a drip calculation, and I nearly made a mistake by trying to move slowly. At that point I said, "Screw it", and just relaxed. I fell easily into a rhythm, and just took the questions as they came. The questions weren't easy, but I didn't think they were terribly hard either. I had to think, but none of them were too difficult to reason out. I was pleasantly surprised that at least two answers of every question were blatantly wrong. There were a lot more "select all that apply" questions than I expected--maybe as much as 20%.

I wasn't keeping close track of the question numbers, and looked up just as I submitted #75... and then the screen went blue.

When I was escorted back out front, the proctors we freaking out. "Done already?! That's a new record!"

Personally I feel like HESI was more challenging because it was much more in depth and detailed on each topic. Of course I don't know for sure that I passed NCLEX yet, but I don't think I'll be losing sleep until I do get results.

One less thing to worry about.

Now to get back into the gym.

Pinning Ceremony

Next up in the Graduation-Season-Gala-Extravaganza-Event was our pinning ceremony. As you can tell from the left there, I finally made it to the big screen. The 100" plasma screens at my church that is. Our pinning event was held in my church building, mostly because I was able to negotiate an amazing deal on the cost, and as a venue it was pretty much perfect. It was a big point of contention that the school itself (because pinning is not a school supported event) was going to charge us out the ass to use their facilities. On top of that, if we held it at the school, on top of the rental fees, the audio-visual department within the nursing school would have to provide their services for a mandatory fat payment suggested donation of $1000. Given their track record, I we didn't want them to have any part of our ceremony. Not to mention the principle of paying to use facilities at an institution we'd just paid $40,000+ to, to earn the degree in the first place. Thankfully because I'm good friends with the facilities manager at our church, we got an amazing buddy deal. Full venue with professional audio-visual for a mere pittance over what just the audio-visual would have cost us at the school.

I gave my speech pretty much verbatim as posted here, save for a few added inside jokes (thanks for the suggestion Will). I also took the opportunity (and advantage of having a microphone) to tell my wife that I loved her when I made the point that we needed to tell those we love that we love them. I have it on good word from those that she was seated next to that it brought some tears to her eyes (mission accomplished). The speech went over well, and I received many compliments from families of classmates--complete strangers--as well as classmates and faculty. I enjoyed being up in front of so many people, and mercifully I wasn't the least bit nervous.

Here is my lovely wife pinning me on stage to the tune of Coldplay's Life in Technicolor. I really was privileged to be pinned by someone I love so much, who also happens to be an RN and working member of the profession. I even caught her getting a little teary eyed as she pinned me.

My service to the pinning committee was providing the venue, the heavy lifting, and the occasional reality check to the estrogen infused pinning committee meetings. There were essentially two other people that bore the brunt of the rest of the organizational duties, and they did an amazing job. The faculty present gave several comments to how nice our ceremony was, and how much they enjoyed it. The entire ceremony went off with only a minor hitch or two, which was gratifying considering the amount of work involved.

Overall I'm glad I was involved as I was in the planning and execution of this event. In the past I wouldn't have bothered with something so inane and peckish. I hope that's a sign that I'm really going to take to this nursing thing.

Sigma Theta Tau Induction

The whole Graduation-Season-Gala-Extravaganza-Event was kicked off on Wednesday evening with my Sigma Theta Tau Induction ceremony. Yet again a masterpiece of misinformation and lack of communication. We were told the event started at 1630, only to arrive and discover it actually started at 1700 and was running behind, so more like 1730. We had left the kids unfed at home with my parents and sister (who had just arrived in town a couple hours before), because we were sure we'd be home by 1800 or 1830 in time to get them their dinner. Some hurried instructions by text and the kids were provided for so my parents and sister didn't have to deal with hungry-cranky kids.

The ceremony was nice. It was even more nice to see my friends from school that I hadn't seen in awhile because of Capstone. And especially nice to hear that one of my best friends and study partners got a job on the same unit as me at Gargantuan Hospital. I'm so very grateful to be going through the critical care internship and orientation with an already established friend and study partner. I have to say I'm much more confident going into this with my tried and true study crew. (She's the one standing next to me in the picture there on the right.)

When it came time to be "corded" various members of the faculty were rotating through, cording each of us after we were handed our membership packet. When it was my turn, who should be the next faculty in line? The only faculty member I've gone to the Dean about because she physically threatened me when I questioned a quiz question in class, and then later kicked me out of her office when I tried to reconcile the situation during office hours.

Nice.

She just hung back, refusing to cord me. So a really awkward situation resulted, and I ended up being corded by someone I've never taken a class from.

Whatever.

Interesting to note, my wife immediately recognized this faculty member from her own days as a student at our CON. My wife received clinical excellence awards for every clinical she was a part of...except for the one led by this faculty member. She was the only faculty member that my wife (the most ultimate get-alonger ever!) had an issue with her entire nursing school experience. So it runs in the family apparently. Her class called this faculty member "The Wicked Witch of the __________" (Fill in whatever direction you're facing at the time).

It was a very nice ceremony though, and I appreciate the honor.

(Although the keynote speaker mentioned that Sigma Theta Tau was like the Ya-Ya Sisterhood of nursing--yay me!)

Pinning Speech (or, All I Really Need to Know, I Learned in Nursing School)

Remember my Sally Fields moment? Well here is the bulk of the text of my planned pinning ceremony speech. I'd love to hear what you all think. (Unless you think it sucks, in which case don't tell me it sucks, just tell me I might consider going back to the drawing board...). My pinning ceremony is the morning of December 16, just a week away. Graduation is that night.


As we draw close to the end of nursing school I find myself looking back over our time here. Now granted we’ve all lived from test to test, from memorizing each drug to the next, and from one disease to yet another pathology. Nursing school is clearly about taking care of patients and helping people get better, or not get better with dignity. But somehow I can’t shake the feeling that nursing school is about so much more than that. If we boil it down to the very simplest terms, some sort of academic red wine reduction sauce, nursing school is about, well, life.

Now that thought immediately brought to my mind the famous poem by Robert Fulghum, “All I Really Need to Know I Learned in Kindergarten”, which is of course, pure genius. I rather like the view from the shoulders of giants, so I give you, “All I Really Need to Know I Learned in Nursing School.”

1. A bath and a tidy bed will make anyone feel better. I’ve seen it time and again, simply straightening a patient’s bed invariably elicits the comment from a family member, “Oh, they look so much better today.” This isn’t any less true in the rest of life. Stressed out? Overwhelmed? So much to do that you just don’t know where to even begin? Make your bed. Bad day? Overworked? Stretched to your absolute breaking point? Take a bath. You’ll feel better on both accounts, I guarantee it.

2. There are few things better in life than a good nap, a good meal, and a good poop. As nurses, if our patients are eating, sleeping, and pooping, their prognosis is pretty good. In the larger picture, when we came into this life, eating, sleeping, and pooping were first three things we did, and I’m pretty sure we got it right.

3. Speaking of poop…it happens. Ignoring it doesn’t make it go away. Or smell better. It’s best to simply clean it up and move on. Remember, very few people aren’t completely mortified when their own poop comes to light—always, always do your best preserve their dignity. Apply that to the poopy things that come your way in life, and it still rings true.

4. Always keep careful track of what goes in, and what comes out. Balance is a good thing. We all had I&Os for our patients drilled into our heads in class and clinicals, but this applies to so many things: bank accounts, raising kids, our minds and our mouths. Think about it. Don’t spend more than you have. Fill your children with the good things in life and you’ll never worry about what will become of them. Fill your own minds with truth and knowledge, and the words that you speak will never embarrass you.

5. Assess the patient, not the monitor. How many of us have gone sprinting into a patient room because the monitor was showing a lethal rhythm or an ugly 02 sat, only to discover the patient sitting up and laughing in bed? In real life, people may have impressive resumes—a litany of accomplishments and achievements, but that should never substitute for your own assessment of their character. Listen to your gut, it’s almost always right.

6. Details matter. Write things down. Time and again I hear people say how much it’s the little things that make a difference. Remembering the small things will make you a hero to most people. Keep a journal, and occasionally read over it. A little self-clarity can never be a bad thing. Every major change begins with one tiny detail that’s altered.

7. You don’t always have to wear gloves when you touch people. We talked about this in class—that human touch means so much to patients. We’ve learned the value of therapeutic touch, but again, this applies to even more so to real life. When we open ourselves up to people, we truly begin to experience the beauty of human relationships. When we leave our protective barriers behind and take off our gloves, we are truly able to receive—and give—love.

8. Sometimes it’s just time to let go. Who hasn’t taken care of a patient who we all know will never get better. The patient suffers, and the end result is the same. In life how many times do we go down the same road, making the same decisions, expecting a different result? Sometimes it’s just time to let go.

9. Always ask for help when you need it. As we transition from nursing school to real life practice, most of us will feel like we have so much to learn yet. Something I’ve learned in my short years on this earth is this: When we get right down to it, people love to help each other. Helping one another makes us feel good. Allowing someone to help is often just as beneficial for the helper. Again this goes back to allowing ourselves to be vulnerable, and admitting that maybe we could make it on our own, but it would be so much easier if we just allow someone to help us.

10. Tell the people you love that you love them. I know that in clinical at some point during nursing school we’ve been party to a patient dying unexpectedly. Gone before their time, or passing on before family can make it to the bedside. As nurses we have the privilege of being present for births, and for deaths, and nearly every kind of moment in between. We should take the lessons we learn from our experiences with others lives. Be sure that you tell the people you love that you love them.

And so here we stand at the close of one journey, and on the verge of another. Through the years, each of the 4 semesters, the 6 am clinicals, the exams, the OSCE’s, Assignments 1, 2, and 3, we’ve grown together to be a family. Oh sure, we each have some of us that we can’t hardly stand to be around, but we are family nonetheless. I want to thank each of you for the privilege of making this journey with you.

Well done Class of December 2010, and best of luck with the future.

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.

Content

I've been whittling away at my 8 12-hour Capstone night shifts on the Transplant ICU at Gargantuan hospital. As of this morning I've done 5 of the 8. I'm back again for the next 2 nights, and then a chaser shift on the 7th. At that point I will have completed all the requirements of my nursing school for graduation.

Transplant ICU has been interesting. I have a really great preceptor--so laid back--we fit perfectly. I've felt good about my contributions to the unit, and it's been great learning another aspect of ICU nursing.

In fact, this morning as I was leaving from shift #5, I found myself reflecting on the state of my life at this point, and a sense of well-being washed over me. The air was chilly, and the sun was just coming up. I was snuggled inside my college of nursing hoodie, and walking to the remote parking felt good.

I suddenly realized, I love my little ICU world. I love micro-managing my patient's care, and controlling every vital parameter. I love that the difference between doing well and crumping can be just a few mg/dL, or a few mmols. I love things as simple as writing vitals every hour, putting my mark on the chart stating, "I assessed this patient this hour, and things were good," or "things weren't so good so I..." I love that when patients go bad on the floor, they come down to me. I love the look of relief on the floor nurse's face when I take over responsibility for the patient's care. I love that docs ask me what I think the patient needs, and 9 times out of 10 they're on board with me. I love these things.

I love that I'm almost done with school. I love that the school and professors have thrown their worst at me, and I've met every challenge head on and succeeded. I love that I've excelled not only in classes, but in clinicals even more so.

I love that I have a job waiting for me. That I beat out 758 applicants that had been screened over the phone. I love the tone of respect in other people's voices when they hear which hospital I've been hired into, because it is truly a fantastic organization. I love the tone of respect in other nurse's voices when they talk about my home unit. I heard a Transplant ICU nurse say that on my home unit, "All the nurses are oddly intense."

I love that my wife truly gets what I'll be doing for a living. I love that I can complain about docs or nurses or lab or RTs and she understands why I'm frustrated. I love that I can throw out a set of vitals or lab values and she's appropriately shocked or mystified without me having to explain it.

Most of all, I love that my little, beautiful family is still gathered tightly around me despite the journey I've been on. I love that the kids still scream "DADDY!!!!" when I come home. I love that my wife kisses me and says, "Good job."

Life is good.

This? Is Not Good

My inaugural 5k race is coming up on Thursday.

I haven't been to the gym in 3 days and the way I feel makes tomorrow seem iffy also. I've come down with a cold that has settled comfortably in my chest. I'll spare you the gruesome details, but if my patients coughed up some of the funk I've hacked up recently, I'd be grabbing for a sterile specimen cup.

Lucky for us it's forecast to be 47* and rainy for the race.

In other news I've started my Capstone hours. I've been assigned to work nights on the Transplant ICU at Gargantuan Hospital. My preceptor rocks, so that takes away the sting of not getting to spend the time on my home unit.

Oh and today my wife and I are preparing Thanksgiving dinner for 53 people at a low income housing apartment complex.

Welp, back to the kitchen.

Something Wicked This Way Comes

So I did it. I registered for the NCLEX. $200 for the test, $139 for the background check, and of course whatever the fingerprinting place chooses to charge me. Nevermind this is like the 4th background check in the past 3 years. With the same company. And of course I have to pay every time even though they need only pull up my file and hit "Print" or "Submit" or "He's a Good Dude", whatever their button says. I wish I could just take the NCLEX now and get it over with. My hope is that my ATT comes in time for me to take the test before we leave for our cruise. But of course I'm at the mercy of the BON. My CON FedExs their part of the paperwork at 8 am the day after graduation, which is nice. No extra charge you know. I guess that's covered by the $20K of tuition and fees...

The one section of the "Candidate Bulletin" that made me a little nervous follows:

NCSBN may cancel or withhold a candidate’s results if, in NCSBN’s judgment, there is a good faith basis to question the validity of the results for any reason, notwithstanding the absence of any evidence of a candidate’s personal involvement in irregular activities. Evidence of invalid results may include, but are not limited to unusual answer patterns or unusual score increases from one exam to another. If a candidate’s result is cancelled, revoked or invalidated without a finding that the candidate engaged in irregular behavior, the candidate may appeal the decision and/or will be offered a free retest. An appeal is the candidate’s exclusive means of redress with regard to NCSBN’s decision to take this action.

Basically, if I read it correctly, they can cancel your score for any reason that they want to. This is reminiscent of my experience taking the ASVAB several years ago. I scored a perfect score, and the recruiter assumed I cheated. I was made to take a paper version of the exam with a monitor sitting in the room with me to ensure I couldn't cheat. I scored another perfect score just to spite them.

Bastards.

Honor Roll

I received a notice in the mail a couple days ago that I'd been named to the honor roll for last semester. I'm appreciative of the honor, but I'm a little bewildered. I didn't do any better or worse last semester than previous semesters, but it's the first time I've been named to the honor roll.

*shrugs*

Who knows.

Ding Dong...

...the mighty exit HESI is dead.

1375.

I'll take it.

Next, skills check-off in an hour.

And Rancorous the HESI Lurks

Posts have been a little anemic lately, but for good reason. Tomorrow I take the dreaded HESI. HESI is basically a comprehensive exam over the whole of nursing school. We've been taking sections of the HESI at the end of each course, and I've typically scored in the 1400-1500 range, so I'm relatively confident. However, the comprehensive nature of this final exam (and the length, 160 questions) has me a little nervous. Which is a good thing I think--i've been buried in my HESI review book and doing online practice tests all week. My school is nicer than some as I only have to make an 850 to pass, and I get 3 chances, but I'd really like to just check this box off and move on.

In other news I have my internship interview on my home unit today. I'm sure I will be given a hard deadline for my decision. This leaves me in a tough spot as I don't have a formal offer from anyone else yet. Today is the 2 week mark of when I was supposed to have heard from individual units at Gargantuan Hospital. Also Level II hospital sent out an email stating interviews for the critical care residency will begin next week. And I have heard absolutely nothing from Awesome Children's Hospital at all, after having applied more than 2 weeks ago. They are appearing less and less awesome as time rolls on.

I bought my gown, cap, and honors cord today.

Anyway, that's a little update.

Honors and the Stink

I opened my school inbox last night to discover an email from Sigma Theta Tau with an invitation to join. It was an unexpected honor, and it lifted my spirits a bit after the Level II debacle. The induction ceremony is on December 15th, the day before graduation and pinning. At the very least, it's something to put in my resume and CRNA school application. It also may mean I'll be exempt from taking the GRE for CRNA school as well.

The dues are steeeep, and then I have to pay $12 for my purple honors cord for graduation. And another pin for $45. How is it that doing well in school is costing me more money? Doesn't seem right.

In fact, it just plain stinks.

But not as bad as my nursing school shoes.

Part of our strictly enforced dress code (the faculty will actually write us "tickets" that result in being put on contract if we break the code,) calls for 100% white shoes.

I hate white shoes.

But I have faithfully worn my solid white New Balance 622s for the last 2 years, and now they stink.

Nay, they REEK.

I noticed the stench got much worse after Hermine (that b*+ch,) soaked me from brow to toe. And it's quite embarrassing really, but I'll be danged if I'm going to buy another pair of $75 shoes for the next 2 months never to be worn again.

Maybe I'll try soaking them in bleach water. Or maybe that biological odor spray we save for the c-diff patients.

Anyway, that's the Honors and the Stink.

Oh Say Can You See...

...by the flickering lantern light.

So my female counterparts on the pinning committee have apparently been lamenting the lack of tradition in our pinning ceremony. Never mind the fact that we're having it on the same day as graduation (per tradition), buying class pins (per tradition), having them pinned individually by the important person of our choice(per tradition), all the while pictures and voiceovers play on the large video screen behind us (per tradition). But that not-withstanding, the ladies of the committee decided we need more tradition.

Their first suggestion was traditional nurse caps, and to have a traditional capping ceremony. Uh... Well, let's put this simply. I am NOT wearing a cap. And I also don't particularly feel it's right that my female classmates get to participate in something while us guys stand around awkwardly trying to find a place to shove our hands in embarrassment. Lucky for me there was enough female opposition to caps that it didn't come down to a "Remember the Alamo!" moment for us carriers of the Y chromosome.

Next on the list of ever so bright ideas was the suggestion that we carry in lanterns, a la good 'ole Flo Nightingale. Except it was pretty apparent that a bunch of giddy nursing students (over a hundred of us actually) playing with fire probably wasn't a terribly bright idea. Especially since most everyone in my class is going to have highly flammable breath due to some in-effective coping as evidenced by heavy EtOH intake. So someone suggested an even brighter idea. You see, "they" make those neat little battery powered candle shaped lights. Apparently they flicker and everything.

Oh Em Gee!! Tacky fo shizzle! Or whatever these young kids say these days.

I am hoping and praying that this proposal dies a quiet and unnoticed death on the committee floor. This is one time my class's astounding lack of motivation and participation could really pay off for me.

I have already decided that if this comes to fruition, I am painting my lantern in orange and black sharpie to look like a jack 'o lantern...

Second Round Away

Two hospitals I'm interested in were supposed to post positions today. One actually did, which is pretty good considering the job postings are under the direct control of the Dark Side HR department.

So I spent a few minutes filling out the online application, uploaded my super-duper resume, and clicked submit.

Now I've submitted to two of the three hospitals I'm interested in outside of the hospital where I currently work. Of course the one I lack is the Amazing Children's Hospital where I want to work the most of all.

Work still hasn't posted their internship I hope because my manager has taken pity on me, but I still feel that dark cloud of anxiety hanging over me. I've applied elsewhere--which is progress--but I hold no illusions over how quickly, or rather how slowly, HR departments move.

On a brighter note, today I picked up a rather flattering letter of recommendation from a clinical instructor I wasn't altogether sure liked me at all. She was my critical care clinical instructor, so that's a big bonus for my apps.

Kind of a heavy duty week around here. I had a test today, 2 to come on Monday, and a chaser on Thursday. Several projects are looming as well. I work tomorrow also, so that's going to cut in on the study time. And I'm watching the kids--last night, tonight, tomorrow night, and all day on Sunday while NurseXX works or sleeps. But that's par for the course, I'll squeeze in some study on Sunday evening and let 'er rip on Monday like always.

Whee!

Skills Test

The powers that be in our CON have decided that we'll be subject to a skills evaluation before we're allowed to graduate. I have no problem with this, it seems only fair. But someone has decided that we are to remain in the dark about exactly which skills we'll be tested over. This is annoying to me, but I feel pretty comfortable as I've been working all along and have routinely done most of the skills I can think of. However, on the other hand, I think it's a pretty stupid policy.

Turns out I wasn't the only one. A few days ago during a class break, I had an instructor I didn't know pull me aside.

"I hear you are the outspoken student of the class," she stated.

"Uh, yeah, I seem to have garnered that reputation," I replied.

"I see. Well, I need you to create a ruckus for me."

She went on to detail how half the faculty completely disagrees with the no disclosure policy. They think it's absolutely wrong, and unfair. Many students may not have performed these skills since Junior I semester, and then only in lab.

So, in an effort to be helpful, I did indeed create a ruckus. I posted the following on WebCT, our official class e-bulletin board:

To Whom It May Concern:

As the skills evaluation draws ever nearer, I find myself
more and more concerned about the manner in which we
are being tested.

Why are the skills we are being tested over shrouded in
such secrecy? I'm finding this to be a serious impediment
to my preparation.

If the goal of nursing school is to prepare us for the real
world, then we should be given the means to adequately
prepare for this evaluation. In real life we would never be
expected to enter a patient room to blindly perform an
unknown procedure. Such a practice would surely
compromise patient safety and put our hard-won licenses
at great risk.

In fact, I believe this attitude of secrecy fosters a climate of
"fake it until you make it" that is both dangerous and could
potentially become an embarrassment to the ***CON.

***CON actively cultivates a reputation of turning out
supremely prepared students. This policy seems in direct
contradiction to the circumstances of this practical exam.

I respectfully request that a full list of the skills in question
be released so that my classmates and I are able to
adequately prepare.

Regards,

NurseXY

And create a ruckus it did. 79 responses later, the thread is still going on.

Have they revealed the skills?

No, they haven't.

Yet.

Don't you just love a good ruckus?

They Like Me, They Really Like Me

I found out recently that my classmates have elected me as the student speaker at our pinning ceremony. Fill in the blank nomination forms were handed out to the class in an effort to put together a list of names to vote on. Apparently my name came up on nearly every page, so they didn't bother with a vote.

It's all very flattering. I mean who doesn't love being loved? I was floating high when I found out.

But then it dawned on me, this means I actually have to get up in front of friends and family and sound intelligent.

Eek!

I've got some ideas, mostly revolving around some cleverly written nursing diagnoses. I'll post my speech for feedback here once it's written.