Will this be on the test?

I find myself giving test-taking tips at every tutoring session lately.

Five tips for taking tests in nursing school: *

• Read the question.

Seriously, read it. Stop, don't look down at the answers yet. Read the question once more, looking for these words or phrases: LEAST LIKELY, MOST LIKELY, PRIORITY INTERVENTION, NOT, FIRST. Underline them when you find them. You absolutely must know what the question is asking before you attempt to answer it. If the question makes you think of that awesome little song that you made up to remember the cranial nerves, go ahead and jot them down out to the side right quick BEFORE you look at the answers.

• Think of the patient.
  

When you study, think of how this will look in an actual patient. If I was in the room with someone who had a Foley cath in, what is the very first thing that I need to think about before that patient ambulates? My list of ALL the things to consider before they start traipsing about would include: where's the bag and who's going to hold it, when's the last time this person got up and should we sit and dangle first, are there any obstacles in the intended path and who will move them, and what other lines do we need to pay attention to (like IV poles, or wound drains, or whatnot). Now prioritize them. What must happen first? What can wait? What means Something Bad and what is an Expected Outcome?
Of those, I think that passing out onto the cold dirty hard floor of orthostatic hypotension has to top the list of Things to Pay Attention To. Having one's foley pulled out with balloon still inflated would be right up there as a very close second.

• ABC, 123.

When prioritizing interventions, as above, or in questions where you are asked to assess a patient and choose the most worrisome data, start as low on Maslow's pyramid as possible.
Airway Breathing Circulation
1 heart, 2 lungs, oriented x3 (who are you, where are you, when is it)
Risk for Powerlessness is always going to appear on my list of Relevant Nursing Diagnoses for any hospitalized patient. Always. Let's face it, laying in bed with no underwear does not increase one's self-efficacy. But I cannot assess anyone's psychosocial needs or even their pain level (which is usually next on my list after the ABCs and 123s) if they are currently not breathing or bleeding out.

• Do another med check.

Patient safety has got to be right up there at the top of the priority list. You have to do three med checks, but four can't hurt, especially if you're in a skills evaluation and you simply can't remember doing that 2nd one before you left the Pyxis. "Put on gloves" is always a good idea, along with "Wash hands and document". The phrase - siderails up times two bed low and locked call bell in reach - is burned into my brain forever. This stuff will find its way onto the written exams, too, so be on the look-out.

• "Call the doctor" is almost never the answer.

It seems like a good idea, I know. Interdisciplinary blah-blah-blah? They're going to have to write the orders? I know. But resist, for just a second.
Think about this - What are you going to say when she returns your page? Stammer, stammer, the patient uh, is, uh, doesn't look right and I think you should come down here. Click.
Assess before paging anyone - unless it's a code that you think you should call, and then holler away! Think through the information that a consultant is likely to ask you if you paged them - axillary temp, blood pressures for the last ten minutes, hematocrit levels, intake and output totals for the last 12 hours? What is the thing that made you worry about this patient and what information do you need to gather about that worrisome sign or symptom? Get it all written down, and then call (abcd - assess before calling doc).

*of course, I only know about MY nursing school. I know that all nursing students do skills evals, but I don't know if you will be able to talk to yourself throughout yours the way we were encouraged to do. I think these are pretty universal, and not just based on my Fundamentals professor. of course, your mileage may vary.

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!

dude. so much to say.

worked all weekend last weekend. skipped class this morning because I stayed up all night watching a disk of House. had a mini-crisis (almost entirely self-created) last week because I hadn't done an assignment that was worth 50 points of a 1000 point class average. At the same time, it was a 6-8 page care plan for a stroke patient - you know, integral skills to have for the field! The stuff that I'll be doing non-stop from here on out in nursing school! eep. Eighteen mini-panic attacks later, I turned it in, not even late, and complete with all five journal articles, cited in APA format. This time the payoff for resolving the drama that I created wasn't so good, didn't really feel worth it. fuckit.

Finally went to Campus Health to put my cloudy, smelly urine in a cup and find out if it's a uti without the pain and burning (i've been symptomatic for about a year now, and have only recently had health insurance and easy access to a clinic to see someone. Can we say functional limitations in healthcare?) Starting cipro today and I even managed to advocate for a follow-up urine sample to be ordered to ease my mind that it is resolved with the drugs.

Signed a lease on a passive solar apartment yesterday - wow oh wow it is cool! big windows, brick floors, W/D, and no pet rent. exactly what I wanted, although not on the side of town I was hoping for.
May is looking a little crazy-making - finals the first week, a much belated birthday party for the kid the second week. The semester starts (with my first clinical rotation!!!) and later that afternoon, I'm leaving for a four day retreat in the mountains in the third week, and then I'll get to pack and move before June 1. sigh. I really don't understand how I've been able to pay a security deposit before the summer fin aid dispersement.

found out this weekend that one of the cool kids from work is going to join the Army for six years. I teared up, and then handed him my address like I was in the third grade and had just found out my family was moving to Georgia. I was embarrassed, and sent this email today. Still a little embarrassing, but it feels resolved now.
Hey R!
I saw you on campus the other day, and realized I could look up your email through the campus directory. I wanted to apologize for throwing a little tantrum the other night. It was such a shock to realize that I wouldn't see you again at work (and since that's the only place I see you of course, then it's not likely that we'll meet again). I was a little surprised at how upset I was, and didn't really know what to say (or what was appropriate to share without being creepy and weird, you know?).
It's odd to think about the loss of a close acquaintance - you are someone that I'm always happy to see, and who I really enjoy talking with. I like the way that you are sarcastic, but not often nasty (probably since I think that I tip that balance too often toward just being rude, as opposed to funny or clever). You manage irony without being an asshole - which is a rare gift, it seems. I think that you're crazy smart and genuinely a sweet person. You remind me of my kid in a way (and I know that's weird to say - and possibly to hear) and that's most of the reason that I was upset to hear you are going into the Army. I don't know anyone personally who is serving in the military right now - and so I'm privileged to be (sarcastically) academic and removed from the whole situation.
My dad was in the Marines, mostly before I was born, and I know that it was important to him to enlist, and to serve his time. I also know that he was a unspeakably different person after having served than he would have been without the experience of service in Vietnam, and I usually think of the loss of innocence, the gain of the burden of seeing horrible things. I don't really have a concept of the other more positive pieces that he spoke about regarding his service - the discipline, the feeling of being a part of something that made a difference, the actual 'service' part of serving the country. I had this irrational hope that time could be just frozen, that we could just talk when I happen to work with you, and talk about how ridiculous the world (and the restaurant) is... The thought of you being at the whim of the nutbags running this country's military takes my breath away, truly. At the same time, I want to say that I support your decision, since I know that you've thought it through carefully, and I feel like you have the strength to handle the experience. Other than having a kid, I've never done something like this that so immediately and profoundly affects my life.
I would be proud if my son grew up to be like you.
I wish you all the best. I'd be happy if we kept in touch - it would be good to know how you are doing.

with love, kati

Yep, it's officially reiterated - I'm a geek.

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.

All My Babies

Wow.

I arrived late to the screening of All My Births, and was graciously ushered in by the woman in charge. She said, I'm so glad you came, and you haven't missed the birth! The bit that I missed apparently set up the story of this rural midwife, practicing in Ga. in the 1950's. Part of the story (it's a scripted documentary, which is apparently pretty rare) was to follow one woman, who was actually a part of the community that Miss Mary served, and received good prenatal care. There was another woman who did not come for prenatal care, had had a history of stillborn premature babies and this character was portrayed by an actress.

The birth was incredible. The lead in was stunning. Long shots of Miss Mary scrubbing fingernails to elbows, and then still shots of her supplies laid out carefully around the bedroom on newspaper. She made this delicate little trash bag out of folded newspaper that she dropped her sterile gauze pads into after wiping the mother's vulva. Metal butter dishes filled with water and nailbrushes and more sterile gauze that had boiled on the wood stove. It was quiet, so quiet. There wasn't much moving around, either by Miss Mary or the laboring woman. The birth happens in real time on the film, from the crowning (which amazed me, because the head kept showing and then retreating, peeking out and then sliding back in, over and over!) to the delivery of the head, then shoulders, then slip the rest of the body, and there's a baby!

I cried as much about the tying of the cord as I did about the actual birth. Miss Mary said, "We're going to go on and cut you loose now, little one". I'm processing all the cardiovascular stuff we've been learning this week, about the rapid changes that occur as babies switch to breathing air from receiving the maternal oxygenated blood, and it had a much more emotional impact. Sometimes, learning the details of a process make it less real, more memorizable, more detached and clinical. To see this birth, and really understand what was happening within that child's heart while she's worked on him was astounding. I had to talk to myself about this very logically, because my first instinct was to think of the time in the birth canal like a code that would need to be called if it went on too long.

The sound was apparently all dubbed over, and that intrigued me. Was the filmmaker trying to make it easier to watch? Trying to emphasize that good births are quiet? Or trying to allow the visual to override the auditory? I was expecting more talking by Miss Mary, more chatter to calm the mother - but the chatter in my birthing room certainly didn't calm me, now that I think about it.

I had somehow gotten the impression that this film was intended as a cautionary tale, to show how backwards rural midwives were. And what the flyer that I picked up afterward said was that All My Births was intended to be a teaching tool for midwives of the time. The gracious woman from the Center for Documentary Studies said that the film has been deemed a work of art worthy of preservation into perpetuity, and seemed to think that a DVD might be available. Apparently, the filmmaker had made another film before this with a dry title like Contemporary Obstetrics Today that featured only white laboring women and clinicians. I'd be interested to see that, and see if they were hospital births, and how the two portrayals differed.

In other news, I think that my friend hung up on me today because I responded to her reports of nausea with a dissertation on borborygmi and the reflexive navel-clenching reflex.

There's no crying in Skills Lab!

I had my first tearful scene in a lab today. I was trying (and repeatedly failing) to draw normal saline into a tuberculin syringe with a vanishing needle. The needle doesn't actually vanish, it just pops into the body of the syringe when you push the stopper hard enough. Twice, I pushed it hard enough while I was only trying to push the saline back into the vial to remove a stubborn air bubble. The overall goal of this portion of the lab was to get 1mL of saline into a nice intradermal wheal on a hot dog. The voice in my head said - Jesus, you can't even pull 1mL of saline to inject a hot dog! How can you even think about being able to make it through this program?! And I dropped my second syringe on the tray and stumbled for the bathroom.
Please understand that although I grew up in the American South, I never have been graceful about crying. My nose gets bulbous and red, my sclera is bright red instantly, and within seconds, my whole face is covered in pink splotches of embarrassment/anger/fear. It makes me even more upset, because if i glance at someone and they know that I've been crying (and HOW could they NOT!) and they react with anything approaching pity, I know it's over and I'll full-out sob. I don't know why I've got such a strong denial instinct for crying, but it seems that even after thirty some years of experiences in which I cannot stop myself from crying, I still try.
Deep breaths in the bathroom stall. Positive self-talk. Frantically try to think of a song that will calm me. I try each of these interventions for about 18 milliseconds and am shocked that none of them work very well. I wash my hands, am shocked at the way my face swelled up like Hitch's after eating some shellfish, and square my shoulders to go back to lab.
After properly disposing of the last syringe, and noting that even in emotional crisis, one should always stop off at the sharps containers, I get a new syringe and keep my head down so that no one looks at my face.
Pa-pow. Another needle wasted.
This time, I do remember to properly dispose of my sharps and it's not just the facial reaction, it's the full-crying in the bathroom. I begin to suspect hormonal involvement. I allow a bit more time for the breathing, self-talk, and musical interventions this time. I splash some cold water and then head back to lab again.

epilogue: we had another TA come in to observe us for the final part of this lab, which was IM injections of each other. The TA and the woman I was working with both did the best thing in the world, which was look at me calmly, ask if she might do the injection on me first, and then ignore my tears. By that point, I was starting to be able to joke about it a bit, and recognize that being able to pull up saline into a syringe, while basic, may be something I need to do more than once in my life. I wonder if the fear of being stuck had an antagonistic affect as well, because by the time it was my turn, I was right as rain.

Duck Rice and Croup

the kid celebrated his birthday, not with a hippy ritual in the gazebo of the rose garden walking around the sun and talking about what he's learned in his seven years on earth and hearing good things from whomsoever had gathered, but hanging out in the bedroom with me, watching movies with the humidifier running non-stop. The good news is that we only had one episode of really scary barking coughing gagging dash to the bathroom and crank up the hot shower and sit on my lap while i sit on the toilet and try to tell him that it's going to be okay and he should just relax and not worry so much about how he can't breathe. After approximately seven minutes of that hell, his coughing had stopped, and his breathing has certainly eased, and I left him in the bathroom to get my best diagnostic tool. My fancy new red Littman? Nay. My fancy new black laptop. While the screen got all foggy, and I started to wonder how long we could all spend in the bathroom without meltdown, I confirmed my diagnosis of croup (remembered from an incidence during infancy) and called the advice nurse. Because, of course, I am not the advice nurse. I am simply in the very first semester of nursing school. We haven't covered auscultating for abnormal breath sounds yet in Health Assessment. Hell, i'm just as likely to use the bell as diaphragm on that thing, or put the (very uncomfortable) ear buds in pointing to the back of my head rather than my nose. The advice nurse was quite helpful, very calm and my new best friend. She told me that no, I don't nec. need to make a Saturday appt for the kid, and that since croup is viral, the most common medication would be steroids to open the airway if the steamy bathroom (or head in the freezer, which seems rather cruel and not very infectious-control-smart) doesn't work in 15 minutes (which seems like an eternity when your kid is looking at you like 'Aren't you in nursing school? Can't you fix this shit, mommy?').

Had a very interesting conversation with the mom of one of the kids I invited to his birthday party (note to me: never invite more people than you are willing to un-invite the day before the event.) everyone followed the script: I'm so sorry he's feeling bad, please tell him that we hope he feels better soon, when will the party be rescheduled? But one mom added that her son was out with a bad bad cough several days last week. I casually asked if it got worse at night and came with a fever, which it did, and did he sound like a seal, which he did. Well, there's that mystery solved then - and I managed to not be an asshole (I hope) when I said that I knew it must have been circulating in the classroom, but that we wouldn't have the party so that it didn't go any farther. The kid's got one grandparent undergoing chemo for breast cancer that's moved to bone marrow and one recovering from outpatient biopsy of the tongue. not a good equation.

So, this weekend was a great chance to practice my study skills at home with kid. I have studying in the quiet room of the library down pretty well, but can't seem to get over the hump to reading or doing note cards at home. I whine about how I don't have a table to sit at and spread out my books - in 500 sq. ft of living space, I literally don't have a table. I whine about how the kid and I seem to always be on top of each other, how my usual distracted-ness (which I have learned will take up about the first 20 minutes of any study session) gets exacerbated by the cats or requests to play Thomas the Train on my computer or urges to get up and make a cup of tea or watch just a few minutes of whatever the kid is watching (hey, I like Wallace and Gromit!), ad infinitum. It was a little ridiculous this weekend because I have two tests and three quizzes this week - and have not spent a lot of time keeping up with the reading in either class. the tests I thought that I aced last week with minimal studying came back with good solid B's. damn this seven point grading scale!

Also got to figure out what would happen if I couldn't make it to lab - email the TA and pray the skills can somehow be made up. The kid's dad ended up taking him this morning, and then bringing him to campus after lab so the kid could see my classrooms and the library and then ride the bus back to the park and ride lot. I told the kid that we usually go to the library after class and he asked if we had to walk single-file. it took me a second to figure out what the hell he was talking about!

I'm a little sad that I missed my psych appt and my med eval to get some Wellbutrin answers. I hope that I don't chicken out on rescheduling those.

Last week at work, the chef made fried rice for the end of shift family meal. This has been a bit of a challenge since I decided to stop eating even the small amounts of meat that I used to consume at the beginning of the year. Usually fried rice is made with strips of various meat - and I can feel relatively comfortable that I can scoop around the meat and still get free food. But last week, we apparently had a couple of ducks coming up for expiration soon, and so the chef made duck fried rice. I scooped out a small bowl and started my search and avoid mission in the corner of the kitchen. Sam walked by and said, how's family meal? I shrugged and said it was a little hard to avoid the shreds of duck, but the rice was good. He was all - You're eating family meal tonight?! But you're a vegetarian now! and then his face softened and he got all calm and objective and says 'wow. you must be really hungry to eat that duck rice.' Sheesh - the guilt! I ended up eating brown rice with potsticker sauce and fried wonton noodles. I hope there will be a point that I will have cycled through all the times that I was accustomed to eating meat and worked out acceptable substitutes. Last Tuesday at Golden Corral, I realized that the brown gravy beside the mashed potatoes was probably verboten now, along with all the soups, and that delicious broccoli salad with the raisins and the bacon bits. I'm good with the meat analogues, and the overall concepts of nutrition within a vegetarian dietary pattern. I'm still a little leery of being 'difficult' to hosts - but had good practice last weekend, when i had to speak up at a conference with free lunch that consisted of a big bowl of pork barbecue, buns, apples, and bags of chips.

In other news, got to practice administering meds via NG tube today and gave a plastic butt an enema this morning. nice.

three things I love about the internets this week

One - Cut a hole in the box. (Come on, you know this isn't work safe!)

Two - Put your junk in that box. (Gay Love Rocks My Sea Goat Testes)

Three - Make her open the box. (found at Bitch, Ph.D.)

Seriously, this computer (and more importantly, the wireless connection I seem to be able to find everywhere) have been blowing my mind lately. I racked up a huge bill on my DSL account - didn't pay the bill for months to teach those bastards at Verizon a lesson - and when I finally did pay the balance to get my interweb turned back on, they said thanks for the $286 but now you'll need a credit card to reinstate your account. I don't, of course, have a credit card. So, for about a year now, I've been on dial-up. Dial-up means no big downloads (so no Youtube), and a lot of instability connection-wise (so I avoid getting on the computer when I didn't have a lot of time to devote to babysitting whatever I was trying to do). It also meant, for me, no pdf documents, because every time I'd try to open one, Adobe would jump in and try to do a lot of fancy updates, and my poor computer would freeze right the fuck up. So. It's been a whole new world for this big girl lately. blogs, youtube, time wasting games, in the recliner, in the bed, in the library! Whee!

I've been feeling a little manic lately. It's a shift from feeling like I can't do anything, I have no time and less energy. And I like coming from a place of "sure, that sounds great. let me see if i can work it in!" rather than being so eeyore about the world. But I'm scared of a crash, honestly. I'm also wondering if I'm trying to tie together too many things that are interesting to me, but not nec. related. I'm trying to yoke social justice stuff (with that US Social Forum event this summer and with a drive to finally get involved in war stuff) with health education/parity/accessibility stuff. I'm looking at my ANS chapter and the state board of ANS for opportunities to get good shit on my resume and applications, wanting to stay active in my kid's school (so bring ANS functions to that population), but also remembering that for the most part the kid's school has a lot of well-meaning rich white folks to help out already, and so looking at the city I live in and how to work there (but avoid being a well-meaning white girl trying soothe my own guilt about sending my kid to the neighboring richer, whiter, "better" school district). I'm also looking ahead to my senior year and potential Honors projects, wanting to lay the groundwork and do something I'm actually passionate about, instead of just enough to get the yellow cords at graduation. Ay. And did i tell y'all about finding about the group that trains health care providers (they have contracts for local SONs, PA schools and MD schools) to provide pelvic and breast exams!?! It sounds like the perfect action opportunity for any woman who has seen the Vagina Monologues and hooted and cheered about the cold ducklips. Wow!

had fun in skills lab this morning - we slung each other around in the lifts. It was such a weird experience to be dangling in a fabric sling from a big purple machine.

test today in LifeSpan Development, which I'm assuming will be pretty much a gimme - helping my mom through a master's in psych in eighth grade and listening to her teach as an adjunct for the years since are a major advantage.

test tomorrow in Patho, which I feel less confident about, but I've done a great job of acting nonchalant about it for the bulk of the weekend. taking a nap, dragging letters around and watching The Facts of Life, Season One.

In other news, I have a $50 gift card to target and I have no idea what I'll spend it on! Jeans? Tennis shoes? A rolling bookbag? Hell, I've spent down my fin aid nest egg for this semester to the point that I may need it for groceries!

really here

So, I'm starting to feel like I'm in nursing school. I went to my second nursing student association meeting today, and beyond promising myself to expunge 'um' from my public speaking if I ever decide to run for an office in this organization, I was shocked to figure out that I've been here a month already!

I still have no clue what the prof in Fundamentals is talking about (nursing diagnoses all sound the same to me - and apparently there's some difference between 'as evidenced by neuromuscular weakness on left side' and 'related to inability to use left side of body', though it's certainly not obvious to me!), but the stuff she says is starting to sound familiar. I still don't get it, but I know she talks about it every class! I really feel like the first lecture in that class should be totally reworked - I didn't understand anything of what she said, and it was apparently really important, because I haven't understood her since then. Thankfully, I think I signed up to be on the advisory board for this class - maybe I can bring this up to her then. She is hands down one of my fav. profs!

My big news this week is that I passed my first skills eval - hand washing, sterile gloving, universal precautions with gown mask and gloves, and vital signs !!!! SHEW - what a relief to have that done and done well, according to the teaching assistant. There was a lot of contention among the students that didn't pass those skills the first time - they had to come back later this week and re-do specific skills - crazy stress and lots of folks felt like the variation of TA's was unfair. I don't know - it's not Scantron, and there are specific little checklists to follow... but I did see at least two instances of TA assholery that would have just done me in. Pa-Pow! Apoptosis! I felt lucky that the TA evaluating me was the TA who teaches my lab section - so easy. I think, though, that I will sign up for practice lab sections with some of the other, scarier TA's so that if I happen to get them in an eval, I won't freak out as badly.

My other big news is that I made an A a B+ on my first exam! It was more general than I was expecting, but it feels like I studied the right stuff and knew the kinds of things she asked. It was in Health Assessment, where we talk about what you expect to find in physical exams of patients, and what various findings might mean. We go from head to toe, and this class has a big evaluation at the end of the semester, where we do a head to toe assessment on someone (which apparently takes a couple hours!). We have labs to practice that examination, and this test was over the lecture portion of the class. this A makes me feel so confident that I'm doing what I should be to handle this material. I also have a little more confidence that I can handle this seven-point grading scale! A 92 is an A-, but it's still an A! (Right?!!! Isn't it!!????) oh well, maybe she'll throw out a question that I missed, like the one about what fungusy fingernails look like.

Nice to have two successes this week, since I've got two tests next week. Development, which will be nothin', and Patho, which is making more and more sense as I actually read the book.

So. my dishes are dirty, and my laundry is in mountains. But I'm happy, and feeling good. I'm eating well and remembering to bring my lunch to school most days. I went to the kid's school last week and taught his class to knit - wow! I'm still reading with a couple of kids at his school each week as a volunteer. I'm singing with a chorus led by a woman who used to teach music at the kid's preschool - she's super cool and full of quotes by Rumi and Hafiz about the present moment and releasing attachment to thought. And I'm going to a conference of officers of other Association of Student Nurses chapters this Saturday. The kid is good and super excited about his birthday next week! This birthday really seems like a departure from babyhood/toddlerhood.

In the Beginning...

Bouncing around this afternoon, trying to gather a shitty day into a tidy package to be thrown away later tonight. belly is empty, head is full of all the stuff I should get done and thinking of N.'s advice to do something after class to de-stress before I try to study. sounds good - like get out of bed if you can't sleep within a half hour so that you won't associate the bed with tossing and turning and kvetching, but with soothing, silent sleeping. mmmm, sleeping. I worry, though (of course), that i'm giving myself an out, and that's the last thing this procrastinator needs - I used to tell myself I could read fiction while I ate lunch, and then I'd get up and do my chores, but instead, I'd keep getting up and get more food, and lunch lasted two more hours.

I started with the newsletter from my women's group, timed for Imbolc, which happens to coincide with the full moon tonight. There's a note in my WeMoon asking how I can honor this full moon in Leo (my sun sign), with the barest buds of Imbolc? To me, I think the answer is in all the stuff I've done in just the last few weeks - big changes that were tiny at the time, things that represent a lot of work in the past and microscopic shifts of perspective, and then bing, the whole knot falls apart in my hands. Finally figured out how I could shift the problem I had with arranging kid custody - I stopped ending the conversation when the kid's dad tried to sidestep. magic! Looked at this whole "Be a Good Person" thought spiral from a totally new perspective with a workshop on Byron Katie's Work - and realized that when I'm invested in how bad someone else sucks, I'm waiting for them to stop sucking to start Being a Good Person. poof!

so, anyway, newsletter, yada yada, good stuff, but I want a copy of that poem by Alice Lovelace. She performed it at the beginning of the Praises for the World concert/event in Atlanta a coupla years ago, and I can still hear her voice ringing. In hunting Alice on the web, I find Project South, which I need to know more about. These days, everything is spinning in terms of nursing school - can I work this into a project for an Honors class, can I take my Nutrition book to the elementary school and answer questions from the kids about why mama says some foods are good and some foods are bad for you, can we do some sort of Healthy Behaviors event at the school (with a much much cooler name than that). My disciplines class is really motivating me to think about why I wanted to do this, what I'd like to do as a nurse, and how many of the same reasons that I rejected nursing as a high school senior still hold true. I have this weird sense of pressure to get all those things wrapped up and eradicated before I graduate - gender roles bullshit, racial disparity in education from a myriad of causes, socioeconomic hierarchial limits. So, I'm reading this site in those terms - how can I get in with these folks and learn the stuff they're laying out, with the plans to apply it to prevention nursing, community health, equity of information kinds of ways. And, as always when I'm reading very carefully phrased mission statements and such - what is it exactly that they do?

So, on the eve of Imbolc, with the barest buds of spring, I know I've got another six weeks of winter (at least) and another three week Mercury retrograde period to get through before the action of spring really begins. I also know that the seeds I'm planting now are what will bloom then (hopefully), so I'm going to spend some time thinking about what I'm flinging out into the field.

I ended up with the last few paragraphs of this speech by Alice Lovelace, given this time last year about some stuff that's close to my heart (the role of artists for change) and something coming up this summer apparently that I want to know more more more about.
From Chaos to Clarity: The Price to Be Paid by Alice Lovelace

now, i will go do my Nutrition homework and start studying for Health Assessment.

Paper Bag Bookcovers

The sum total of my academic work this weekend was reviewing my flashcards once, deciding that half of them are silly, printing out the stuff for my Skills lab on Monday, and covering my hard-backed textbooks in paper bags, ala eighth grade. By far, the most satisfying was the book covers.

I remembered how to make the little pocket to slide the book's cover into. I was tempted to get out my kid's crayons and draw the names of the courses on the books in bubble letters. And I was quite disappointed when I realized that at least half of my books are soft-backed, and can't be covered in paper bags at all. (or at least, it would be dumb to do so, and probly DEcrease the life of the book.)

One of the reasons I did this is that I had a flashback to the room in the house where I grew up, with at least one whole floor to ceiling book shelf full of my dad's engineering and math textbooks and reference books. I always wondered why he had so many, since I couldn't remember seeing him pull one down and look at it. But as first one, then another professor said during their first lecture that one of the ways to succeed in this program is to buy the books and keep them, I realized that he had them because they were the books of His Field. They represented the choice of careers that he had made (and stuck with - interesting to a thirty-something pursuing her first bachelors' degree). They represented his accomplishments during college. Not insignificantly, they represented a monetary investment. I paid $729 for the books for this term. I've taken 15 hour semesters at the community college, I've had big bills at the bookstore, this was not a total surprise. But the idea that I won't be selling these books back as soon as I walk out of the final exam is a new one. I've always used Pell Grant money to buy books at the bookstore before - and apparently, that's not the way it works here. I got my fin. aid check and then paid out of my checking account for the books. It's the biggest transaction my little debit card has seen in many months. I couldn't help thinking of the sum in terms of months of rent, phone bills, tanks of gas.

But it's really cool to think about beginning to build the collection of books that I'll have in my office one day. They may be completely obsolete in five years. Many of them are full of maddening backwards language and ridiculous doublespeak - referring to people with "yellow skin" in a chapter on cultural sensitivity, using male pronouns throughout with no note at the beginning about why the authors chose exclusive language, including blithering pop-psychology as factual evidence for the importance of non-verbal communication skills. But they are my reference texts. They represent my entrance into a Field of Study. and they remind me of the things that my dad had to give up to earn his college degrees for his chosen profession.

When Things Settle Down

Dear Mom,
Remember how hard I cried the first week after I went away to college fifteen years ago? Remember how I said that I never would have come if I had known how hard it was going to be? Shouldn't fifteen years which encompassed an entire life span of a marriage, the birth of a child, the death of a father, and countless years of accumulated successes and failures have mitigated some of that emotion?

I've survived the first week of nursing school at BigSounthernSchool. After attending lecture last week, I made the following to-do list:
Be a Good Person.

According to my professors and textbooks, nurses are caring, attentive, selfless, open to new ideas, creative, calm and professional. They are reseveroirs of knowledge, advocates and teachers. They use good communication skills, show flawless emotional control and time management skills and are devoted to the health of their patients above all else. I begin to wonder how I will acheive this in only two years.

The first two days felt like one big blur of faking-it-til-I'm-making-it. With no clue, a thousand wishes and a million fears, we all dashed around to find classrooms (or not), see people that we recognize (or not) and collectively we waited for Things to Settle Down. Hopefully, I won't be too far behind in the reading when this finally happens.
For weeks before the semester started, I've been busy at home, shopping for books and looking at campus maps and bus schedules. Apparently, that was all for comfort only, because I never actually bought the books (everyone's already read the first chapters of everything), am lost immediately upon stepping onto campus and take the wrong bus for three days in a row (oddly enough, three different wrong buses). I was also busy constructing a thousand assumptions. No wonder I'm lost. How can I come to this open? How can I dive through the fear and get to the thing that needs doing? I sit in the library and wonder what needs doing. With each breath, I know. With each breath, I can open and dive. But this moment's breath seems caught somewhere small.

I'm lost. There's something in the feeling itself that can allow me to string together the times I have felt small and sad in a long heavy chain. But the the beads of all the days that I have grown larger and brighter scatter and roll under furniture. The joy is finding those beads in a dresser drawer somewhere. with love, kati

P.S - Things are Settling Down a bit. The doc from Counseling and Wellness who addressed us at Orientation had a slide that showed a much higher rate of grad students than undergrads come to the office for counseling. She said that grad students see the value of free psych services when they see it. I'm not a grad student, but I'm old enough and poor enough to perk up when I hear the words "free service". I've got an appt next week - let's see how good your free services are, nice lady.