aqui, no mas *

Quick run-down:

Maternity - test this week on labor and delivery, extrauterine transition of the newborn, newborn care and teaching. take home points: Babies should be warm, pink and sweet and labor hurts a lot. Aforementioned clinical drama. Excellent patient interactions for two weeks running now.

Public Health - 92.1 on last week's test. Proud of the studying I did - in small chunks, used textbook for making study sheets, even though I never read before class. Also aware that this is one class where more studying likely will not bring better grades, but taking more time to read the questions will. A big relief.

one of the Disciplines - panel with new grads for class this week. Take home point was there's a relatively high rate of job-changing 1 year out of school, and attrition rate from the profession altogether. Choose your workplace based more on the co-workers than the patient population - it's never worth it to work with nasty-assed people. Also made the mistake of sitting in the back of the class, and listened to the back row bitch and moan and make snide comments the whole time. The irony was lost on them, of course.

the other Disciplines - watched the movie Wit with Emma Thompson and cried unabashedly. Excellent, excellent movie. Fodder for hours of discussion. I will have a hard time limiting my paper to a page.

Spanish - survived another conversation hour, complete with dialogos enacted in front of the class. received positive feedback on paragraph re: the usefulness of the pain scale with patients who are not native English speakers. I said, Shit, it doesn't work so well with patients who ARE native English speakers. Again, did not die during public speaking en espanol.

Patho tutoring - still need to drop off paperwork for payroll. Held session on SuperBowl Sunday night - 25 students showed up! I was thinking, maybe 10 would come! What's worse is that we were doing my weakest lectures - immunity, B's, T's, NKs, types of hypersensitivity reactions and classes of antibodies. survived.

State Board of ANS - another marathon meeting, this one with hours of driving attached on both ends. It's looking bad for our upcoming mid-year conference, and it's hard for me to get all gung-ho about it because it's so clear that most of our activities are merely for self-perpetuation. Approved an operating budget of $65K at the last meeting that included $1000 for scholarships. AND that pittance took over an hour to agree on. excited about nationals in Texas in March, sad that I didn't get my shit together for a resolution, excited about folks planning outreach projects with kids. also, i'm a big dummy and volunteered to take the minutes and have yet to send them out. shrug.

Honors - hmmm. Thought a lot about this. It seems a little insane to take another thing on this semester. But I've been wanting to do an Honors project since I started the program and was thrilled when I squeaked through with the GPA last semester to qualify. So I decided - Yes, I am doing this thing. Now, I just have to find an adviser in the next five days to sign my intent to participate form. hmmm.

the kid - getting my head around re-districting for next year. processing more worrisome progress reports from the teacher who doesn't have credibility with me, and from the art teacher who was more worried that I thought was appropriate. planning birthday hockey game with friend.

the house - rearranged the living room, with the bookshelves I bought for shoes two weeks ago. Nice to have the lake of shoes off the floor behind the front door. Appalling to see the amount of cat fur that builds up in two weeks. Dishes are going on 13 days now since original use, although they have been rinsed and stacked in varying arrangements twice in that time.

in the category of Nothing to do with Nursing School - hang on, I know there's something... hmmm. made new list of scholarship applications due on March 15th? no no that won't do. chinese food with friend which included discussion of nursing school, but also of her new job and dying cat? better. did taxes, and was impressed that I managed to earn only $4K last year, down from $10K the year before. Now that's gross income! badumdum. attended Friends meeting. good. very intense feeling of peace this last week, lasted about 4 minutes. distracted by making mental lists of this weeks errands. watched leaves blow outside.

*literally - here, no more. I've heard it used to indicate to a professor that one is present in class, but not at their best that day, so don't expect a whole lot.

the next week-ana-haf

It's not going to be pretty folks. Not pretty at all.

First off, tis the season to begin calculating what I'll have to get on my finals to maintain or improve my current grade in each course. And then, because there's still time left in the "fart around" block on my calendar, I can calculate exactly how far the 5 credit hours of a B in Peds is going to sink my GPA and if there's a way to recover. Since there's approximately 42.5* hours total left in my schedule for studying, and my other exam grades this semester have been 98, 85, and 84, it seems unlikely that I will score the 99% that I need on the final to make the cursed 92=A**. sigh.

today is a bust - but I did get the presentation for Thursday's genomics class done, and have about another hour or two to spend on my clinical worksheet for tomorrow, and then I'm taking my movie back to Blockbuster and getting something dumb like Fred Claus.

Wednesday 11-28 - up at 5:20a, leave home by 5:55a with lunch and hard boiled egg breakfast, drive thru coffee kiosk by 6:13a, park and ride lot by 6:22a, hospital by 6:42a, conference room with oatmeal ready for report by 6:46a. Twelve hours of 14 yo with idiopathic scoliosis s/p spinal fusion due to 41 degree curvature, logrolling q 2hr, monitoring morphine PCA and IVF, possibly d/c a foley and hopefully think of something to keep him from being bored out of his skull. I wonder if he plays chess? Catch the bus by 19:08, park and ride by 19:22, home by 19:51, feed cats, shower, eat something that doesn't require me to wash the dishes, make tea, finish worksheet, email genomics ppt to prof, trade out the laundry, scoop cat shit and collapse in bed by 23:28.

Thursday 11-29 - alarm at 6:12a, snooze til 6:32, leave house at 6:55, park at elementary school and feel slightly guilty for not saying good morning to child by 7:15, coffee from library coffeeshop at 7:38, sneak into lecture hall past man who yells about food and drinks by 7:51, Peds from 0800 to 1100, Genomics from 1100 to 1200. Get food from bookstore, take bus to elementary school, work on missed assignment from week before last in Research in school multipurpose room til 1330. Collect reading buddy, read Bear About Town and A Color of His Own, return buddy, collect new buddy, repeat. Return to MP room at 1430, refocus on Research assignment and lament the lack of reading completed for this class all semester. At 17:45, present self at Music Room for assistance with the Herding of the Parade of Children for the Multicultural Gala, in which child will be singing "Hello to All the Children of the World!" and cheesing it up as usual. Stay as short a time as possible, corner ex-husband to review end of semeter schedule, demanding a commitment for child care during next Saturday's scheduled final exam in Research, and dash home. Repeat Wednesday's evening activities at home, without the genomics email and with the added joy of supervising ready-for-bed activities of child.

Friday 11-30 - alarm, snooze, park at elementary school all as per Thursday's schedule. Present self at the library at 07:25 to work a shift at the Book Fair, collecting quarters for pencils and imprinting credit cards slips in an old ca-chunka credit card thing. Bus to campus, coffee from bookstore, lecture hall by 08:58 at which point all the good spots will be taken and I'll have to climb over five rolling bookbags and six laptop cords. Psych lecture from 0900 to 1100, and ATI test from 1100 to 1200 to heighten my anxiety about finals and my Lack of Mastery of the Material. Lunch with friends that I haven't seen in two weeks because of conference and then the holiday. Research at 1300, for which I will realize that I haven't prepared at 12:47. Prof will read her ppt, break us into small groups and then release us an hour before class is scheduled to end. Buy a 20oz Coke, and go to library for 1hr 15min to print out everything I can think of to use up my printing allowance for the semester. Bus to elementary school. Collect child from after school program, who will not want to be collected, and who has likely forgotten one of the following items: lunchbox, jacket, Gator Communicator, water bottle. Go to Food Lion for veggie chick'n nuggets, juice, bread, milk. Home. Cats. Dinner. Bed for kid. Write agenda for committee mtgs tomorrow, and reports for my position for November, and goals for the year for meeting tomorrow. Wish there was wine in the house. Bed for me.

Saturday 12-1 - Plan to get up at 0700 and study for an hour, then at 0800 to go to farmer's market for eggs from the Happy Chicken guy. Sleep in, and wake kid up to go to whole foods with friends around 0945. Wake up friends. Go to Bank and deposit amazing Merry Christmas check from Generous Aunt which will make it possible to avoid working any shifts at the restaurant during finals week. Mentally thank Generous Aunt again. Sit around drinking coffee and eating overpriced underdone scrambled eggs for an hour. Leave child with friends, remember that I forgot my scrub top at home for group picture and go get it. Drive to nearby city for board of directors meeting of state nursing student association - struggle to find parking and arrive at bldg 12 minutes late. Meet until 2pm, avoid snapping at abrasive board members, and find a way to discuss grammatical errors without offending. Pick up kid, chat with friends, offer to take her child to park with us, go to park, knit while kids run. Drop off kid, offer to spend some of Generous Aunt's money on dinner for the four of us. Eat a lot of delicious breakfast food. Go home. Glare at the cats, their shit and the still-unwashed dishes. Also, on Saturday, I have 2hours worth of work to do on my clinical presentation due next Wednesday, which includes a 2page paper, 2 articles and a handout for my classmates on my interesting case study. Do this and then spend half an hour shopping for vibrators and dildos.

Sunday 12-2 - shit. I have no idea. schedule reads Peds from 09:00 to 12:00, county library with kid from 12:00 to 14:00, childrens museum from 14:00 to 16:00, grocery store from 16:00 to 17:00, dishes then dinner then dishes again from 17:00 to 19:00. There's a note that a chorus meeting is from 13:00 to 15:00 at the Friends Meeting House, but I don't know if I'm going. At some point, kids' father is sposed to pick him up for a roller derby match, but idk when. schedule also notes more Peds study time from 1900 to 2200, but that is unlikely. More likely that I will be on the computer until 0100, paying my bils with Generous Aunt's money and deciding on yarn for that afghan I'd like to start over break.

Monday - 12-3 get up at 06:18, leave house with kid (and whichever of the four essential items that made it home on Friday) and hardboiled Happy Chicken eggs and go cups of juice by 07:08 to be able to park at elementary school by 07:38, get kid inside before 07:40 bell. Buy the kid's stocking stuffers (with G.A.'s money of course) from the Book Fair. Collect reading buddy at 08:00, read for 20 min, collect another buddy, read, and then walk to bus stop for bus to campus. Coffee from coffeeshop, up to favorite nesting spot, plan to spend nine straight hours studying Peds and Psych. Fuck Genomics and Research. The finals are worth 40% in those classes? Oh. Spend an hour obsessing about grades in all four classes and filling in next semester's academic calendar. Spend another 30 minutes getting a latte, toasting a bagel and checking email. Wish that I still smoked and could take a smoke break. Force myself to go back to nest and sit down for another 3 hours. Take last bus to park and ride lot, forget that car is at the elementary school, take bus back to campus and then back to elementary school. Get home by 23:00. Glare at cats and their shit. Feed them, then go to bed.

Tuesday 12-4 - this morning is going to be hard. I don't have anything *scheduled* until 10:30 (which is my first dentist appt in SEVEN YEARS, and I'm a little Anxious About It) and it will be tempting to sleep in. I would like to get up at 0700, shower, make coffee and quick breakfast, then sit down to look at Peds for two hours before going to the dentists. After dentist, park and ride, campus, read Research in hospital lobby. At 15:00, go up to unit and get patient assignment for Wednesday, research chart for two hours for clinical worksheet. bus to park and ride, car to elementary school. home, cats, dinner, dishes, chess, kid = bed. clinical worksheet, set five alarms, self = bed. Remember to email clinical group my presentation and print multiple copies of handout and articles.

Wednesday 12-5 Okay, this morning will be harder than Tuesday's! The kid has to be at his father's workplace at 06:15 for me to have time to drive to parking deck and be ready for report at 06:48. I don't even want to think about when we have to get up. clinical until 19:00, parking deck, whole food buffet which had damn well better include some macaroni and cheese, home, cats, shower, type up clinical worksheet from a day's worth of scribbled notes. wait to email it until Thursday to allow for one more editing opportunity - I need every point I can get on these worksheets for that mythical 92! tea, email, check for an episode of house, fall asleep during it.

Thursday 12-6 I would like to get up at 07:00, be at the library at 07:45, get coffee and a study room, and spend all day on Peds, with short study breaks of Psych and Research thrown in. Maybe meet with study partners from last two semesters, but I'm feeling like it's a bad idea to study with them for the first time this semester the day before the final. I really hope that next semester will allow for some more regular study times when we're all on campus. This semester, it's been scattered all over for clinicals M T W, and in class from 8-4 Th and F. Rescheduled Reading Buddies to another time, maybe Monday morning. Eat a good dinner, take a bath, lay out my clothes, and set five alarms before I get my 8 hours of sleep.

Friday 12-7 Peds final exam 09:00 to 12:00 Get to campus early enough to get coffee and a bottle of water. Sharpen pencils. Layer clothing. Read each question three times, underline key phrases, circle any negatives, check each answer backwards - does the answer make perfect with the question? I will plan to be there until noon. I will not dash out of the room to be the first one done because I'm nervous. I will also spend 5 hours on Research Friday afternoon, and repeat the whole Twas the Night Before a Final routine Friday night.

Saturday - 12-8 Research final 09:00 to 12:00. I am too exhausted to even think about this.

Sunday - 12-9 Write Genomics paper on asking my family about their medical history over the holiday

Monday 12-10 Psych Final 09:00 to 12:00 Write Genomics paper on Case Study Project. Read all Genomics powerpoint slides

Tuesday 12-11 Genomics Final 09:00 to 12:00 Collapse into small quivering pile.

Wednesday 12-13 I've decided that this would be a good day to donate platelets. I don't know WHY I decided this. I've also scheduled myself to work a lunch shift on this day. I think I'll keep the platelet appt and release the shift - I deserve a day on the couch with a season of Scrubs, a big bag of Grandma Utz's potato chips, some sour cream dip and a two liter of coke. mmmm.



* Oops, make that 41.5. I just spent 30 minutes catching up on Google Reader and I'll spend at least 20 constructing ridiculously long sentences here.
**It's not even a real 7 point scale. 100-92 = 8. Dammit! It's annoying enough to make 92 the lowest A, but don't call it a 7 point scale if you do so!

Condition is stablilizing

I have plans for t-day break. Big plans.
I'll be in the car for 12 hours total with my stepfather, who wants to always be the driver, and my mother, who doesn't like music in the car, and my son, who has been a little surly, and my own head, which is spinning at usual nauseating speed.

I'll be spending 12 hours a day assessing or avoiding the assessment of my grandparents, who don't want to be assessed, thank you, but who each want me to assess the other!

I'll be off to the county library if the dang place is open, to use the free wifi and try to get the paperwork sorted through from the national convention (fun, revolving restaurant, iceskating, focus sessions good, met the president of the american holistic nurses association, sad about the lack of cohesiveness on my state's board). I'll work on a day in the life post, and I'll do some research about whether I'm willing/able to write a resolution for the NSNA convention in March. i'm also going to work on a FAQ for poor folks who go to national conventions, and sketch out an article on nursing blogs before ANA gets all in my business with their nursespace.org stuff...

I'll be playing chess with the kid, writing stories with the kid and then passing the kid a Captain Underpants and Super Diaper Baby book and taking a nap on the blessed baby duck-upholstered couch.

I unfortunately will not be working any shifts and trying to get out of this gaping financial maw which is the end of the semester. I will, however, be eating my grandparent's food. I will pay the low low price of wearing a nice sweater to t-day dinner for this privlege.

But did I mention the drive yet? it's the part I dread the most, though it's not going to be as bad as all that. Every time we set out, I think, this will be the trip that I buck up and say that I'm ready to take over driving, so that he can choose either passive or aggressive once and for all. Maybe I'll just do the first leg of it this year, and get all Cesar Milan about it. Shht!

I tell ya one thing - I am pretty damn tired of everything that's coming up for me being something that's playing out in the kid's life now! I am feeling like a giant projection screen, just showing him how to become a steaming bowl of crazy of his own! had a relatively good follow up conference with his teacher today - but I leave there feeling a little slimy, like it's going to take a few hours of steady thinking and writing to get clear about what I think about what she said. too much work, people!

speaking of crazy, it's ridiculous to whine about being tired and looking tired, but staying up. I turned off the alarm this morning, and we slept in til 8:45am because he didn't go to sleep til 10pm and I didn't turn off Scrubs til 2:20am. so. good night.

ouch.

Why is Blogger offering to type in Hindi for me? Did I select something or is this some sort of blog worm? ah, never mind. I can't be bothered.

1. i have a headache. likely because it is in fact quarter til two and my ass is not yet in my ridiculously comfortable bed, with the window open to ridiculously cool air.
   
2. my tonsils hurt. like i've been smoking american spirits, which i HAVEN'T and so this sucks super bad. i've had right tonsillar megaly for about two years now, and at some recent visit, hopefully not my annual pelvic, it was deemed 'no big deal'. But it hurts. it feels like the nasal passages are inflammed? is that anatomically possible? I just want to figure out a way to squirt some warm water somewhere that will make it feel better! Gargle? Snort? Mouthful of it and breathe through my nose? flark!
3. i have my first clinical in peds on monday. I'm terrified. this won't surprise you. more details below.
   
4. i am contemplating asking the principal for a transfer to the cooler 2nd grade teacher from the asshole 2nd grade teacher. the risk in asking? that she might say no, and then I'd have to resign myself to dealing with the asshole all goddamn year and I just don't know if I work myself up to ask for this, and then I don't get it, how badly will that actually suck?
5. I. must. stop. signing. up. for. things. Run for election on state Board of Directors of Assoc of Nursing Students? Excellent! work with LGBTQ folks on my side of campus? Great! Read with kids at my kid's school twice a week for an hour? Super, thanks for asking! Work on the World AIDS week planning committee? Okay! Go to the Global Health Committee meeting because it might mean inroads with the community health folks at the SON? wellll... Meet with SON folks about gay stuff? good idea, but is this the semester for it? sigh.
6. i got a haircut today. i'm growing out the crew. shaggy surfer boy chin length here I come. in the meantime, I'm working on how to make it less fuzzy looking. the stylist said that using scissors, not clippers, will help. and smoothing serum. and i'm driving home, thinking, yeah, having it be all one color instead of salt and cinnamon might help, too. Who AM I that I wash my face twice a day, pluck my eyebrows, purchase and actually wear kitten heels, apply nailpolish, and consider dying my hair again? it's like a remix of the 80s. I thought I was done with all these femmey trappings! (also planning the breast reduction I want with my signing bonus. eep!)
7. my dishes still aren't done. yes, it's been at least 3 weeks since I updated. i still haven't washed that lasagna pan and i only recently ran out of clean gladware, so I actually will have to do it now.
   

Peds Clinical
Get this - Summer was my first clinical rotation, right? Med-surg, adult health, GI floor, lots of ostomy bags and wound vacs. Tube feedings and such. I only had a pt with a NG the last day of the rotation, and managed to fuck that up by removing the old nasty tubing to the canister and throwing it away, gettting distracted on my way to the supply closet to get new tubing and getting called back to the patient's room bc he was nauseous bc i had left him off suction too long. i still don't get NGs.
So, after that 11 weeks of patient care, I had a week of finals, three weeks off for break, and then the first half of the semester was my psych rotation, where it's simply not a good idea to touch the patients. I did vitals on the unit one morning, and I took a BP for a man who was having a hypotensive crisis (with a seated BP of 72/54 and a standing BP or 62/42, he was sent back to his room to wait for the physician - thank you for the excellent example of how to NOT provide patient-centered, competent care). No direct physiological patient care in about three months.

My first shift in peds rotation will be in the PICU. I'll be there for only one shift. I'll go in at 9a, get info on my patient. This is at a hospital where I've not worked yet, so I have the access codes for the computer, but have never used them. I'll come back at 1pm and work til 7pm with this patient and a preceptor, whom I've never met. I was thinking that this was fine, because it was just going to be observational, right? They won't let me touch really sick kids, will they?

Then I read this paragraph* in the syllabus, while looking up what to wear. It took me ten minutes to calm down and realize that I won't be in the Peds ED tomorrow, that's not for another two weeks. Then I started to freak out again when I realized that the only IV that I've ever started was on my lab partner, and the canula kept sliding out and I tried to shove it in with my finger... I'm all about the psychosocial support. I'm *very* supportive. Drawing blood? Fuck that. I gotta go.

Okay. Time for bed. I'll be up in a couple months, when it's winter break.

*Clinical Experience: The student will spend time in the Pediatric Acute Care in the Pediatric Emergency Room setting, where he/she will participate in caring for acutely ill children. Included will be nursing interventions such as triaging patients; assisting with procedures such as assessments, IV starts, blood drawing, teaching families; and providing psychosocial support to children and families.

research, addiction and other things I am angry about today.

My friend told me that I was very distractable today. I didn't really listen to her because I was trying to figure out how to get one of those cute little KEEN shoe keyrings... I also wasn't listening because I'm jealous that she gets to take her Master's degree in Research and roll out at noon on Fridays, whereas I have to remain on campus for at least three more hours, and possibly as many as four more hours. It's just horrible.

I turned into that back of the room asshole today in Research. After one prof read the damned slides verbatim to us, and offered nary a word of additional information or real explanation, another prof flashed a list of journal article titles on the screen and asked us to tell whether they were primary or secondary sources, and if they were empirical or theoretical. From the title alone.

I get that if it says review, it's secondary and if it says exploring or study, it's primary. But for one example, she said that it was not theoretical although SoandSo's Theory of Anywho was in the journal article title. We murmured and buzzed like the courtroom of Matlock when Andy Griffith makes his startling revelation, and she said, yes, it's empirical, because SoandSo didn't deal with these other subjects when she developed her Theory of Anywho, and so this article is actually creating a theoretical model, but not dealing solely with the theory.

Um. Prof? I have a question. Since we haven't studied SoandSo, nor her Theory of Anywho, we would not have been able to reach that same conclusion. I personally am still not clear by what you are using as the definition of theoretical framework and theoretical model. Will this sort of question appear on the midterm that you keep alluding to in such vague and threatening ways each week?

sigh.

We had a guest lecturer in Psych today, talking through Psychopharm and fucking it all up.

Five minutes into the lecture, she said, in essence, that if someone becomes tolerant to a medication, they are addicted to it, and that addiction and physiological dependence are one and the same*. When several of us in succession raised our hands and explained that that was directly contradictory to what we had learned in Pharm and Adult Health and Fundamentals, that the bigger concern for the general population was untreated pain due to a fear of addiction, that addiction is a pattern of behavior motivated by craving the euphoria effects of a substance, not the physiological tolerance that most people develop to drugs like narcotics.
She responded that we should challenge our professors and question that teaching (and I'm thinking that is a ridiculous statement to make, when although a Guest Lecturer, she is still a lecturer and should have some concept of the rest of the curriculum of the program, especially before she rolls in and starts talking shit).

To add insult to injury, this class is a combination of second semester accelerated students, third semester traditional 24 month students, and last semester traditional students. So, the seniors are just so over our questions, and one of them eventually raised her hand and said, all snotty, Can we just move on? It seems that we're not getting anywhere with this. I cannot imagine saying such a thing to a professor. It's really amazing to see entitlement in action at 10am on a weekday.

Ridiculous Guest Lecturer also told us that she is more likely as a nurse practitioner to adjust someone's lithium levels based on their experience than based on their levels. Sure, sure, know the levels for the boards, she says, and yeah, yeah, hydration and I&O's are important. but I think that a tremor is a better indicator of toxicity than a level over 1.2.

In good news, I got a voicemail from the lady with the testing company that administers the Nurse Aide Certification test that I took and failed on Saturday, and I think that she hinted that upon review, I did, in fact, pass it. I don't believe shit until I see the score report. I dare them to tell me that I have to spend $22 and an entire morning answering scenario questions about what to do when you find a patient masturbating and how to properly handle a patient who doesn't want to eat breakfast and throws it at you, whether to abandon the patient you are transporting when a fire alarm sounds and my very very personal favorite (I actually laughed out loud when I read it!), whether it's a good idea to respond to a patient touching you inappropriately by touching him appropriately and asking him how he likes it?

A busy day tomorrow:

• eggs from the happy chicken guy at the farmers market at the crack of dawn before he sells out, because they really do look and taste sooo different and better and because he has a photo album for the love of pete, a photo album, of his chickens and the Great Pyrennes who herd and protect them from predators.
  
• Pride parade with the kid, bouncing between the gay parenting folks and the gay students from the university.
• haircut for the kid, because school pictures are Tuesday and he's a tad shaggy. Incidentally, I'm thinking of growing out the crew cut and going for the chin length shaggy surfer cut that the boys are sporting these days. I love it.
  
• museum to see them feed the bears and give Kongs to the lemurs
• home to remove the clutter that has accumulated, and police the house for shoes, trash, and stray tumbleweeds of cat fur.
  
• spend AT LEAST an hour on notecards for peds, since there's an exam next week, and another hour reading the material for research, which may enhance my experience in the course a bit.
  
• make brownies and watch the disk of Scrubs that Blockbuster so thoughtfully mailed me today.
  

*I thought this phrase was - one in the same - for many many years.

*psst. people on the left, don't tell the people on the right, but we hate them!

my friend reminded me of that paula poundstone bit recently.

Yesterday was tough - orienation for psych clinical, which I hadn't realized I was nervous about. Additionally, my usual clunky awkwardness was exacerbated by the fact that I spent four hours sitting in a room with Ponytail Perfect Priscilla and her flawless-skinned sister Elizabeth and their five friends, Polly, Perky, Baby Spice, Paris and Azaela. I am not a person who looks smooth and polished, not even when I think that I do to be honest.
I have unkempt and overly hairy eyebrows, which I pluck erratically. I have persistent adult acne, which I keep thinking I'm spend a portion of financial aid money to fix, but then get all caught up with utility bills and other luxuries. I have thrift store clothes, which no matter how carefully I inspect at the store and at home and after the inital run through the laundry, invariably have a stain on the butt, or a hole in the armpit or some such thing.
It's cool with me, usually, really it is. I have lived in this messy body for 35 years now and I'm okay with it, usually. But it's hard to remember that I'm good enough, smart enough and doggone it, people like me, when I am stuck in a room for hours on end with no reality check with folks that are cuter than me, slimmer than me, and doggone it, firmer than me.

So I went to water aerobics last night, and hung out with my people who have rolls, big ones, and not just boring old belly rolls, either. This group has ankle rolls and triceps rolls and I love them. I worried at first that my comfort was at their expense, that I loved these women because of that subconscious habit I have of scanning the room to see if I'm the fattest woman in the room. And I've decided that one of the reasons that I feel comfortable in the locker room is that I see other women who have thighs that look like mine. A whole room of women who have that canyon-y thing around their navel (I wonder if they know that if they squish their belly in the right way, it looks like either a butt or a bagel?!)! Joy. Happiness. Belonging.


The worst part of psych today was walking on the unit. After that, I was cool. I fucked up by not saying goodbye to the patient that I was talking to when we left the unit to have lunch and do our notes. I need to brush up on my open-ended questions. I kept asking informational, factual type questions, and then we'd sort of stare at each other for a bit, and then look back at the TV, or at the man who was grinding his teeth loudly enough to be heard across the room!

The other worst part of psych is that all summer I was in the swanky private hospital (which has places that are sorta gross and undesirable) to the federally operated hospital built in the 50s and not renovated since. Four and six beds to a room, with common showers and bathrooms! This weird yellow tile brick in the walls. Hallways that are pre-fab and feel like that ramp you walk down to get on the airplane. Staff bathrooms that make me regret heartily the bottle of water I carried with me. Big oil paintings of the President. A cafeteria that smells like mustard and old eggs, not sushi and oatmeal bars for breakfast. Where's all those footpedal faucet handsinks? Snort. Still giving patients Haldol?! Sure, it's cheap because it's so old. Course, that's the reason why most folks who can afford to don't use it anymore, because there's a thousand things safer and better...

off to look up whether bruxism could be a form of extrapyramidal side effect... Jo?

If I make 205 out of 250, I can pull a B.

But apparently, not a B+. And this is something that I have never worried about before. It seemed a little snooty to be all about the A+ or the B+, because I thought that GPA was just based solely on the letter grade, not the plus and the minus parts. But now I'm all sad and pissed because I should have been wavering between an A and a B in that class, but after losing points on four skills evals over the semester and the Most Awful Final Exam in the World, I'm trying to keep the B.

not to mention the pluses and the minuses.

damned seven point grading scale. i don't like it one bit. there's no wiggle room!

ow.

still burnt. applying aloe liberally. wincing each time I reflexively swing my backpack onto my shoulder. today, i managed to pull off the cute swingy shirt with crocheted sandals, but the sandals made little blisters on the inside of my heel and by the end of the day, I was carrying my shoes in my lunch bag and both of my bookbags in the other hand.

These blisters were invisible compared to what my marathon-running friend showed me yesterday. She said that the first aid stands were pitifully stocked and six miles apart. (I'm thinking to myself that I haven't walked six miles in years, if ever!) She said, "When it burst, I screamed out loud. But after a while, it just sort of went numb." She finished the race, within her time category. I stopped whining about my bra straps cutting into my sunburn for a while after she told the story.

Developmental exam yesterday seemed super easy - and stayed relatively on the surface of the EIGHT CHAPTERS of material it covered. I love the affect of the prof for that class, but she told us that to prepare for the test, which covered material with only one corresponding lecture, we should 'focus on the text'. No. the word you're looking for there is 'read'. When one focuses, one often has a shorter list than 250 pages to attend to. shrug. I thought I blew Health Assessment out of the water last Thursday and pulled a half-hearted 89. shake shake shake and roll.

I have a Fundamentals test tomorrow that is so difficult to study for - not because I've finished Barack's book, or because I had dinner with friends last night and tonight, or because I spent all weekend at a CPR class, getting a sneaky sunburn, and 'focusing' on eight chapters of developmental psych. It's hard to study for, because it's the mamby-pambiest material stuff of the class that already seems to slip out of my fingers each time I study it. I can't remember a bit of the last test, only that what I studied for that one was not on this one. The material we're covering is Stress, Sex, Aging, and Med Administration. I just don't trust that it's as easy as it seems. here's my study guide:

• Be prepared to be directive when patients are exhibiting signs of sensory overload or ineffective coping.
  
• Patients should use alternate positioning after hip surgery (though we never elaborated on this, and I felt I had pushed the boundaries of appropriate class discussion far enough when I asked if sex was considered to be an Activity of Daily Living by most texts).
• Old people are useful, and you shouldn't use baby talk when addressing them.
• If you need to give someone 50 mg of a PO med, and the tablets are 25 mg, then give the patient two.
  

I need to make a list of the random nursing questions I have. My addition today would be - why no more than three tablets at a time? Is this as random as provide patient care from the right side of the bed?

Speaking of stupid questions, let me leave you, gentle reader, with this gem. We had an information session about next semester today regarding how to register for the section of clinicals you want, and how it's not uncommon for 100 students to register in 3 minutes, so set your flipping alarms, and pay that parking ticket by Friday. After most everyone had left, Another Student asks if I know what exactly we'll be doing in clinicals. I have the same question, so AS and I trot up the Dr. Undergrad Dean. After a brief lead-in by AS, I say, "I mean, will I ever be alone in the room with the patient this summer?" Dr. UD looked at me carefully and said, "Yes."

I am going to have to be a bit more careful about what I say, lest I become the talk of the faculty lounge. Who is that short-haired sunburnt woman? Why is she always asking such ridiculous questions? Oh, don't worry, she came from a community college, and those students always have a difficult time transitioning.

Shhh, that doesn't hurt!

At the park yesterday, I was trying to study Patho while the kid was playing on the big slide. I wasn't having much success. There seems to be a cloud around this particular park - I can't relax and let the kid play here. I'm always watching the other kids, sitting on my hands, and biting my tongue to keep from yelling at kids that aren't mine to stop jumping on their little brother's head. Why I brought my notebook and that ginormous textbook I can't figure out.

This dad puts his daughter up on the swing. She's less than 6. The dad already put the under 2 yo in the baby swing and she's happy and safe. The dad pushes the swing, the girl slips out and lands flat on her back on the ground. Wham. Silence, and then a gasp and crying. Now, in my head, I'm rooting for the dad. Get down, I urge, down on your knees in the dirt right this second. He complies to a certain extent, crouching, but still looking around him, not at the baby, but for witnesses. Dude, I think, it's cool, I saw it and I've done it before. Everyone who has pushed a kid in a swing has had at least one time that they weren't ready, or you pushed too hard on the first push. Get down on the dirt and pick her up in a big hug. Now.

He ignores me, and starts talking. Uh-oh, I think, he's shaking off the signs from the catcher. Bad move, skippy. He says, Shhhhh, now. Hush, honey. You're okay, it's okay. Okay, so I get the motivation to reassure. Fine. But the hushing? At approximately 3.2 seconds post-traumatic, scary thwumk on the hard ground? Get real. That is a- not going to happen, and b- ridiculous of you to suggest.
They are about 10 feet from me for this whole encounter, and I am unfortunately blatantly staring while he continued to argue with her about the severity of her injuries and hugged her too hard (which made her cry harder and yell at him to get offa her). At one point, he started saying I'm sorry that you fell and hurt yourself. I'm so so sorry that happened. Hedging, dude. Weasel-y. Bad call.
I really don't get this impulse to blow off kids. You can't win by saying to a kid yelling that it hurts, that no, it doesn't. Um. Yes, it does. No, it doesn't. You might mean that it shouldn't, or that it's inconveinent for you to be yelling about right now, or that I don't have it in me to muster the sympathy that I should be showing you, or that I think you are a big fat baby whiner. But as the person not experiencing the pain, trauma, or discomfort, you cannot say that it does not hurt.

True, this girl made some noises like she was dying. Like she was about to fucking expire. Like Scarlett OHara when Ashley left her and the Yankees came to Tara. In my opinion, she made those noises because she doesn't feel like her dad is listening. She has learned in five short years that she has to ratchet up the drama in order to get him to engage, even though he engages poorly when he finally shows up.

The girl screeches, with raggedy breaths, I want to go home. The dad says, Well, how about this, honey, why don't we - and the girl screams it again. The dad gets annoyed. Dude, you're using too many words. I know that you're thinking out loud. I do that, too, all the time, and I know that it's annoying to many around me, including my kid. There are times when you are better off shutting your mouth and thinking. Anything you say that is not, Okay, baby, let's go get our stuff and go on home - pointless, like that Far Side cartoon about what dogs hear. blah blah blah. So your thinking time needs to be devoted to any reason why we cannot go home right now, and that reason needs to be limited to they are exterminating our house with dangerous chemicals that will affect our neurologic functions.

Turns out that the reason the dad was hedging on the pack-it-up-and-roll-out idea was that he wanted her to get back on the horse. He thinks (I saw it above his head in a big balloon) that if he lets her go home crying because of this fall, that she will always be scared of swings and this will be a weakness for the rest of her life. Been there, too, man. I totally understand. But stop it. First of all, at no point in this process have you, the adult, the one who did NOT just get hurt and scared, not once yet have you shut the fuck up and just hugged the kid. Try it, please. You have demanded that she be quiet, repeatedly commanded her to take a deep breath and calm down, and told her that it's not a lot of blood and she shouldn't be scared. Stop. Take a deep breath of your own. Sit with her. Listen to what she's saying. Look at her eyes. Let her know that what she's saying, what's happening for her is important to you. Hold your own agenda for a second - of not looking like an asshole that just pushed your kid off the swing, of making sure she doesn't develop a lifelong swing phobia, whatever.

I kept wondering if she would respond to me if I went over with water for her to wash her fingers. I kept imagining that I would do all the right things, and like the Dog Whisperer, she would instantly quiet and calm. I think that I did not go over because I didn't want to know that this movie was totally fiction.

What I did do was pack up my own books and kid after the second time he came tumbling out of the slide crying. Apparently, their clog-up-the-slide-halfway-down game had gone awry and he got a foot in the ribs. Okay, I said, matter-of-fact, Time to go. Of course, I muttered 'just like I told you it would be if you kept playing that dumb-ass game with that big kid who was jumping on his brother's head'.

It really makes me wonder what other parents think of me on the playground.

i hate nursing school.

I'm very happily in bed, staying up way too late to go to that silly walking tour of the wildlife preserve tomorrow at 8am and comforting myself by calling it silly and whining in advance about how early it starts.
I'm reading about scrotums and books and the controversy when the twain shall meet at bitch, ph.d. good stuff. reminds me that i need to actually get a hard copy of a wish list for reading started, instead of just thinking, Oo, I'd like to read that and then always feeling like I do at the video store, that there's tons of movies I've wanted to see, but not able to remember a single title.
And then the kid is all with the loud, irregular breathing. Honestly. Take last weekend's croup, a sleep study that found him to have moderate sleep apnea* last year and this week's content on Respiration in Health Assessment and I can barely fuck around on the computer anymore what with all the freaking out I'm doing mentally. Even if i muscle through and don't freak out right now, it'll just creep up on me randomly in the future when my defenses are down. Now I have to go google apnea again. Oh fuck! Was that Cheyne-Stokes!? this is not funny. it's not okay. I thought nursing student disease was when you were convinced that YOU have all the diseases you're studying, not your kid! me, fine. the kid - fuck this. i'm outta here.



* when the doc was concerned about his tonsil size and I was concerned about the number of times I hear him quit breathing before I fall asleep (nothing like your kid's desperate snort of apnea for an adrenaline rush!). His dad's sposed to be a CPAP machine himself. whee!

Oh Dorothy Orem, why doth thou vex me so?

I feel a bullet blog entry coming on!

• My test this morning in Fundamentals was hard. More than one question about the formatting of nursing diagnoses, which I am not so clear on, and less than one question on the risk factors/outcomes/interventions for the specific nursing diagnoses covered in these chapters. I feel like my studying wasn't very effective for this test, and I'm not quite sure how to fix it. Perhaps I'll begin with an appt with the instructor, whom I love.
• Did I mention that I got Bs on both the developmental test that I was so sure about, and the Patho exam that I strutted out of feeling all confident?! pride do cometh and alla that.
• I'm trying to decide if I should go to the Health Action Committee meeting for PTA tonight. On one hand, it's been on my calendar for weeks to talk to one of the women on the committee who works as a school nurse about mentoring for possible ANS functions and personal mentoring type stuff. she's super cool. On the other hand, I have a thousand things to do tonight, and the meeting is sposed to run til 9pm. there's only so much I have to contribute to a conversation about peanut allergies in the elementary schools and making sure water is available in the lunch line. I can talk to the mentor lady anytime, I suppose. My main concern is that if I start skipping this meeting (only once a month) then I'll keep skipping this meeting. pish.
• Before I go to bed tonight, I have to make a casserole for a random family I don't know because I got an email asking for folks to participate in a dinner delivery service for this woman in the nursing program ahead of me who just had a baby, blah blah. number one - she is in a two-parent household, so I'm a little snotty about her need for provided food, but I can quickly see that's selfish/irrational since I was in a two-parent household when the kid was born and I would have been thrilled beyond measure for strangers to bring me a casserole. number two - stop volunteering for things. just stop it. number three - what the hell am I going to make for her, when my child and i have been eating veggie chicken nuggets, defrosted frozen peas and mac-n-cheese with spinach this week. I have this mental picture of Black Bean and Sweet Potato Enchiladas, with a batch made up for me, too. I just don't know if that's realistic.
  
• Three hours and ten minutes until my test in Disciplines. It's 40% of the grade for the course, and the only power-point presentation that the instructor has done was three slides long with a definition from Nightingale, Henderson, and the state board of nursing about how to define nursing. Do I need to get all detailed about the Henry Street Settlement? It's really interesting to me. Should I memorize who founded the ANA? Watson's ten carative factors? This is the course that sounds like a lot of words strung together to me. meaningless drivel is my first impression. True, with careful reading and synthesizing from other courses, it's getting more easy to understand and see the relevance. But distinguishing Rogerian nursing from Orem's self-care theory? The difference between a conceptual model and a theory? BLAH! bring on the sick people! Bring out the mannequins and the needles! Let's get to the good stuff. Oops, I'm exposing my occupation of Benner's novice stage of skill acquisition (person barely knows how to do something, is inflexible, and unable to apply said knowledge/skill appropriately).
  
• Going to supplemental practice lab for med administration tonight - which seems smart.
  
• Did not bring texts for Health Assessement (quiz at 8am tomorrow) - which does not seem smart. there's a test, a lab, and a pan of enchiladas between me and that textbook.

in other news, my lunch was not adequate. I'm off to get a latte and a scone.