I'm about halfway through my nth shift delivering flu shots to the masses. Although it is monotonous at times, I've actually found it to be a pretty good experience. I work casual hours which means I can pick up shifts as I like, and I can even cancel a shift if I get too bogged down in school work. I've met all kinds of people, and gotten semi-decent at small talk. I've also developed a mighty smooth IM technique!

Things I've learned from flu clinics: I have absolutely no desire to work with children. Even if the kids are behaving perfectly appropriately for their ages, I find them stressful. Let's not forget the parents who try to convince me that their 7 year old sniveling kid will sit still by himself for the shot.... Not falling for that one again!

I actually find the flu clinic kind of an enjoyable escape from emergency. After the first week, most sites have been VERY quiet. My stress level right now is about -10. After my high-stress city job and a summer in emergency, I almost feel guilty that they pay me to do this....... Alllllllmost :) my favorite part about this is that no one treats me like "a student" here. I'm a member of the staff, I do my own thing unless I have a question. I can make normal conversation with the nurses, for probably the first time ever. It's great.

In other news, it's about 3.5 weeks away from the end of the semester! this semester has been RIDICULOUS. I was walking to school this morning in the pitch black cold and I thought to myself.... Man, 4 years is a long time. I've been standing on this same sidewalk waiting for this same light to change in this same crappy weather holding a coffee from the same Tim's since 2008.

The workload has been a steady insane pace for the last 2 months, and it's shifting into overdrive for the rest of this month. I have 2 more group presentations, 3 more papers, and a bunch of quizzes and minor assignments to complete by December 2. I also have to finish my oncology nursing certificate by the end of November, except that's impossible so I will have to extend it until January.

BUT. And here's the big but.

I have my preceptorship placement confirmed!

I am going to Oncology!

I am so excited!!! The cancer care center here is huge and highly respected. I also had such a good experience with the oncology nurses that I met at the CANO conference in Halifax. With any luck, I will knock their socks off, and be offered a full time line after I am done my preceptorship hours. :)

Assuming I like it there, of course. But I am feeling very, very positive about it.

Honestly, after some months away from full time emergency, I'm starting to wonder if there's a better fit for me. I mean, emerg is AWESOME experience and I can't say enough about the expert knowledge there. The nurses are mostly super kind and helpful. I will absolutely stay there on a casual basis. But, something's missing.....

.... The kind of relationship building that you get with inpatients. The chance to see the results of your hard work. The possibility of being on a first name basis with your client in a real kind of way. The opportunity to really, really talk about health promotion with your clients, the kind of deep talk that happens at 0-dark-thirty.

I mean, those things do happen in emerg, but rarely. The norm is that I'll round on a patient 2 or 3 times and then they'll be discharged. The ones who come back, our lovely frequent flyers, don't usually come for the witty banter or healing presence of yours truly ;)

I guess it's that some of my classes this semester have struck a chord. Especially in my Chronic Conditions class, we really talk about primary health care, and I want to be more involved with my patients in that kind of way. Obviously inpatient Oncology isn't really the place for that. But it's got a chance for that kind of relationship building, and I see a lot of opportunity for primary health promotion at the community level.

I've got my orientation for the hospital at the end of November, and I'm super pumped. It's for the inpatient-side, so I guess that will be a lot of the really-sickies, palliative care, that kind of thing.

Can't wait! Getting so close to real nursing!

So early in my nursing school adventure, I daydreamed about what the upper-level classes would be like. Well, not really the 400-level courses since they seem kind of dry by title alone: Future Directions of Nursing, Leadership, Bioethics of Health Care. I was so excited about the 2nd and 3rd year stuff. Lab skills, patho, assessment. I remember, shortly after I was accepted into the program, staring at the curriculum and wondering who and what I'd be like once I'd gotten to where I am now. I remember seeing myself in some nebulous idyllic clinical representation, the essence of confidence and expert nursing skills, making effortless profound impacts in the life trajectories of my patients. Hahaha :)

Well, as you know if you've been here or if you've read my blog for any length of time - there's really no such thing as effortless at this stage. I overthink the hell out of every move I make, either before I enter the patient's room, or as I lie awake in bed wondering if I did or said the right thing. My romantic ideas of nursing are muddied further by challenging instructors, complex work-school-life balancing, and learning to navigate coworkers and professional relationships.

Anyway, I guess I'm trying to say that my reality is both laughably departed from what I imagined, and in some ways exactly what I hoped it would be.

So that brings me to this year. These courses which I just viewed as the last necessary steps to my final placement and -at last!- status as Registered Nurse. I thought this semester would be the longest one of my life.

Nothing could be further from the truth.

I LOVE this semester and everything about it. We're already 4 weeks in, with 9 weeks to go before finals. Through divine intervention, or a reasonable facsimile, all of my classes have amazing instructors, including some of my favorites from years past.

The biggest difference this year from previous years is the distinct lack of rote memorization. I don't have any lame keywords to memorize for the final. It's like we spent the last 3 years learning (and forgetting a lot of) that kind of micro-knowledge. My lectures this term are all big-picture discussions. We don't spend so much time convincing each other what nursing's supposed to be (since none of us actually know, anyway). We actually talk about realities of nursing, as seen through our experiences in clinical and as UNEs. Macro stuff like is this congruent with what we imagined? Where is nursing as a profession, and where do we think it should be?

Another thing I love is how empowering my instructors are. They are always reminding us about who the future of nursing is, and how it's up to us to make it into what we think nursing needs to be.

I leave every class with my mental wheels turning. I've been known to jokingly complain to my friends about how META my classes are. Seriously, this semester makes me so happy! I think it's shaping up to be my favorite one out of this whole program.

Right now I'm working on my first paper for this term. It's a review of a pop-lit book on leadership. I'm reviewing the book "Primal Leadership" by Goleman. It's kind of a long-winded project since I have to finish the book before I start the paper (due Friday), and amidst my already packed reading schedule it's been kind of a grind.

In other news, I will be working the flu immunization clinics this year. Orientation for that is on Thursday. I fully expect to be amazing at IM injections by Christmas ;)

Thanks to those who added me on Google+ so far! You rock :D

I really have to apologize for the dearth of posts lately. I've got no good excuse except for the usual premium on spare time that comes with nursing school. So that aside...

A Summary: I really want to talk about my experience as a UNE (student nurse extern) in the ER over the summer. I freaking LOVED it. On speaking with some of my classmates, it seems that I got pretty lucky in my placement, because my particular ER is small and ultra-inclusive - there simply wasn't enough help to go around, so I was always considered part of the team, and like an extra set of hands. Turns out some other people placed on Med-Surg/postpartum were viewed as subpar RN stand-ins. As student nurses we are mandated to take a smaller patient load and lower acuity than staff nurses - which makes sense. Yet some of the staff nurses took the perspective that the UNE had it easier and so made their jobs harder, where other nurses saw us as a bonus to the existing staff and as lightening the load by taking a patient away from each of the other nurses.

So I am even more grateful that I had such a positive experience this past summer. I was on the unit from May through the beginning of September. My scope was pretty big. There were a few things I couldn't do at all or without RN supervision, and some of my meds needed to be cosigned, but I worked really hard and helped out a lot. I almost never sat down except for a quick charting session. It got to the point where I was starting to anticipate the flow of the ER and what might be done for certain patient presentations. I asked questions and clarified interventions. I saw several urgent presentations and maybe even a couple of emergencies, although I still haven't witnessed a code or done CPR on a human. I made real differences to several patients. I learned how to work as a team, contribute, and COMMUNICATE. I made more money on shift differentials then I ever expected (woo night shift!!) - but, most importantly to me, I gained so much experience in the nursing role and, like, quintupled my comfort level with all the psychomotor skills that made me so nervous in lab. I saw so much this summer.

Some of my coworkers were more difficult than others to really learn from. One in particular struck me as an exceptionally competent nurse, very confident and knowledgeable, but she was like a prickly pear to talk to. I guess like your typical Type A ER nurse (for the record, I'm pretty much a Type B introvert, and I still enjoyed the ER, so don't let anyone tell you otherwise). I got a lot out of shutting up and watching her, but forget asking her any questions, she didn't have time for students. Or so it seemed. And there was the charge nurse who wasn't the best teacher. But the overwhelming majority of my RN/LPN coworkers were super kind and patient with me. They all made such an amazing difference in my practice and I told them so!

Would I recommend Alberta nursing students be a UNE during the summer after 2nd and 3rd year? Unequivocally YES. It's like nursing school on speed. You'll start making sense of the theory in ways you didn't expect. You'll gain the psychomotor skills to actually do lab skills on real patients without your instructor hovering over your shoulder, and while you do those skills you'll start to work patient teaching into your practice. Then in 4th year you'll have real-world examples to back your shit up when you write papers. Or blogs.

A Conference: I was the fortunate recipient of a travel bursary to the CANO annual conference in Halifax, NS. There was supposed to be another student who went, but I never met her.

In a nutshell, Oncology Nurses are seriously knowledgeable. They are also awesome because, from what I experienced at this conference, they are valued as collaborative and worthy team members even by physicians (kind of a hard status to come by, it seems) and are extremely supportive of complementary/alternative medicine (CAM), not so much because of the evidence surrounding CAM but because patients want it and find relief from it, and they need their primary providers to be open and knowledgeable about it too.

The conference was 4 straight days of learning. Corporations sponsored almost all of our meals, and during each meal there was a presentation on some new wonder drug or different approaches to patient care. There were also a multitude of workshops to attend, where nurse researchers would present their latest abstracts and findings.

I had a lot of difficulty integrating myself into the conference because, as specialists, the presentations were operating at a pretty high level of comprehension. The conference attendees were almost all advanced practice nurses - NPs, CNSes, and tons of nurses in research and academia. They would debate different chemotherapy drugs and weigh the pros and cons, and things like that, which was kind of meaningless to me as a student. There was some stuff I did learn a lot about, such as a yummy dinner symposium at which we learned about treating clogged CVADs. I don't remember learning much at all about CVADs in class. The dinner was beef and chicken. The beef was served medium-rare, and pretty pink/fleshy in the middle. It was at that moment the presenter posted some photo examples of blood clots extracted from CVADs. They looked eerily similar to my beef dinner. At which I thought, "Only nurses would be totally cool with watching this as we eat..." mmmmm :)

Another challenge I found was the huge jump, not only in experience, but in age between myself and the other attendees. Being as they were almost all out of bedside nursing (and with the commensurate experience), I'd peg most of them as 40+. Not that there's anything wrong with being 40+. It just didn't give me much to talk about with them. So most of the time I would sit down with a new group of people at a table, introductions would be made, and they would ask me where I worked.... when I would say "Oh, I'm a student".... and the conversation would awkwardly shut down or divert amongst the RNs. It made for kind of a lonely time at the conference although I did meet and network with lots of people. I even met the lady who does the clinical placements for our local Cancer Care centre, where I am hoping to get a placement for my preceptorship.

The CANO BoD contacted me after the conference and wanted to get my perspective as a student attendee. I think I will recommend that they try to designate a "Conference Guide" for future conferences, who can assist the students to really understand the presentations and kind of bring it all together. I think I would have benefited from some kind of debriefing.

On a totally positive note, several of the nurses I sat with were really pleased and happy to help me understand the presentations. I could see that a lot of them were probably involved in teaching. So that was really kind and super helpful. I got a ton of notes from all the presentations, so I might be able to review them once I am practicing and maybe they'll make more sense. :)

A Project: Through my work with CNSA as Informatics Officer, I have been working with CASN and CNA on developing informatics competencies to add to curricula for undergraduate nursing education. I think it's cool that I'm working alongside some heavy hitters in academic and professional spheres on a project that will impact the future of nursing education in Canada. At our teleconference in August, we needed to elect a chairperson for our committee, and some of them suggested that it would be a good experience for me. I think so too, but I really don't know what I'm doing as a chairperson. I told them that if they were patient with me I'd be happy to take on the role. Part of this means I will be presenting our findings to a stakeholders' symposium in Toronto at the end of November. At our last teleconference I discovered who would be considered a stakeholder. I'm super pumped/terrified to meet these people, but wow, what an opportunity.

An iPad: It's no secret here or anywhere else that I have a special fondness in my heart for Apple products. I was one of the original hires to help open the first Apple store in Western Canada (which was a pretty fun day! :). The love is waning a little bit with Apple's continued pricing structure, surging popularity, and militant control of how I enjoy my products, but, on the whole, I still can't beat the user-friendliness of iOS/OSX. Can't argue with the fact that after I convinced 4 of the family members who called me all the time with computer issues, I don't really have to troubleshoot anyone's crap anymore, because it doesn't need troubleshooting.

So when I saw the reading list for this semester, and noticed how much of it was PDF academic articles, I winced and wished there was some way I could read these in a more comfortable manner. I really try to avoid printing anything because I am cheap and scatterbrained. I also hate reading articles on my laptop because of i) the searing pain in my lap once my computer's been on for >20 minutes, and ii) I am way too easily distracted by Spaces.

So I started checking out some different kinds of tablets. Initially I was intrigued by Samsung's Galaxy 10.1 since I might be converted to Android. I certainly am willing. Anyway, after lots of research and playing with tablets at Best Buy, I decided the extra $50 or whatever was worth the negligible decrease in performance/portability/resolution in exchange for an exploding App Store and seamless integration with my existing tech setup.

Anyway, I bought the iPad last Saturday on an extreme trial basis. I had very specific criteria in order for any tablet to be superior to my laptop. I was/am ready to return it if it didn't work for me:

1) It had to be incredibly easy to integrate with my cloud server on Dropbox
2) Accessing and editing documents on Dropbox had to be seamless
3) Accessing and editing PDF articles and class notes had to be comfortable and realistic (nothing too complicated)
4) Google Calendar had to play nice with iCal or an acceptable equivalent
5) There had to be apps out there to make it superior to my browser-based existence
6) OSK is just not realistic for me, so I wanted a great/portable Bluetooth keyboard

Today is day 5, and honestly, I don't know how I got by without it. I LOVE curling up in bed, locking out the rotation, and reading/annotating my PDF articles or even just web browsing or watching Netflix. I am beyond impressed with how most software seem to integrate with Dropbox or other cloud servers.

Right now I have been using Goodreader to read/annotate PDFs, Quickoffice Pro HD to view/edit my Word/Excel docs, and iProcrastinate to manage my workload. Unfortunately iProcrastinate only has an iPhone app at this time, but it syncs up with my Macbook so it's all good. So nice to be able to see what's coming up next between all my classes.

Tomorrow I will try AudioNote especially in my Philosophy class. The prof is very much a talker, and doesn't tend to summarize her points in any logical fashion, so I think recording her lectures and having them timestamped to the notes would be a great thing. We'll see how it goes.

I have been finding a lot of apps that might be suitable to nurse-types, so I was thinking I might do a review of these in the future so you can get a feel for it without shelling out money.

As far as the keyboard setup, I was heavily swayed by NNR's review of ZAGG's keyboard. I checked out Future Shop and found one open box, missing the USB cable. Since I have a few of those anyway, I sashayed up to the sales guy and asked him to "make me a deal" on it complete with flirtatious lashes. He knocked off another $20(!) for me, dropping the price from $100 to $75. Excellent. I love the keyboard, too, although it's good that I don't have man hands, because the keyboard's certainly petite. Together with the iPad, it still weighs roughly 2/3 less than my Macbook, not including the charging cable, and it definitely takes up much less valuable space in my bike pannier.

So altogether, between the cellular data, the apps, the cloud integration, and the ZAGG keyboard, I am quite pleased with my setup. Bonus points for form factor, weight, battery life, and lack of hard disk drive. I will continue evaluating right until Saturday of next week which is the end of the allowable return period.

Anyway, I have been blogging away from yet another new app - Blogsy. I really like it. Even better than I like Blogger's old back end. I used it to write this blog post - I am hoping that the improved mobility will make it easier for me to blog when I have the desire instead of waiting for when I have time at home with my computer.

I guess that about covers everything. For now. :)

I am leaving in a little bit to my first buddy shift at the ER! I will report all soon :)

I have also just started taking SOCI 271, Intro to the Family, during the spring session at school, as credit for my senior elective. I am SO THRILLED to report that I have begun my 4th Year courses!!!

(I also love spring session because it's 3-hr lectures, 5 days/week, for 3 weeks. Bliss.)

I'm pretty sure I will be a terribad peds nurse.

Today our lab focused on the immunizations clinics we will be running during our Community Health rotation in the coming term. We will be giving Hep B series to Grade 5 students.

I quiver in fear - bloodcurdling FEAR - at the thought of being THAT nurse, the one who makes your kid deathly afraid of needles and healthcare providers for the rest of his or her life, or screws them up forever, and they go on to become political leaders with personal vendettas against nurses like me.

As part of lab today we had to come up with some pre-vax teaching for the wee 10 year olds. My group of 4 had some Official Pamphlets on Hep B that was not designed for kids, and we had to present it in a kid-friendly format.

Harder than I thought.

Every time I wondered aloud as to how we could modify the content, my group said "Don't you remember what it was like when you were 10?"

The answer is no, actually, I don't. I don't have a friggin clue how actual informative speeches should be presented to children. Puppets? Skits? Fred Penner? The one thing I do remember about information presented to me at the ripe old age of 10 was that I definitely noticed, and was filled with righteous indignation, if the speaker was treating me like I was younger than 10.

But how to actually achieve that balance? Urrrgh.

The worst part was trying to explain the means of transmission. I looked at the pamphlet and it was the usual. Sex, drugs, rock 'n' roll, son. I would be comfortable presenting these straight facts to people that I am reasonably confident actually KNOW what sex is about. Grade 12, sure. But Grade 5?

It's so weird too because those who know me know I am not a prude by any stretch. I am a sexually comfortable person and very open minded. But just the thought of telling these kids that they should wrap their tools put my stomach in knots. For NO reason! SO weird! I truly have no idea when these kids move from "when two people love each other very much..." to "hey, sex is fun, but watch the Rohypnol!".

Maybe it's one of those things that will make sense one day if/when I have a Grade 5 child of my very own.

Until then, they scare me. Really. Make them stop looking at me.

The 10-page paper received a 10/10 on "matters of style" and did mediocre on everything else.

The instructor's comments included such things as "excellent writing style but missed the point".

The post that went up yesterday about the CNSA conference was typed up last week, while I was still blissfully unaware that my paper earned (?) a B-. I am glad I applied for the national team already because there is no way I'd apply for it now... self-confidence is in a puddle somewhere around my shoes.

I held a pity party for one last night, thankfully distracted by yoga and a dance class.

Amazing how one tiny hitch in the road can bring back all those memories of being the dismal underachiever in high school... Kinda had the rug pulled out from under me, there.

After some self-reflection, I have come to terms with this disappointing mark (it's more that I am disappointed that the mark doesn't reflect the enormous amount of research I did) and have resolved to bust my ass on the final exam.

Another L&D lecture, another class full of wide-eyed stares and quiet gagging.

Dear L&D nurses, I admire your fortitude.

I'm going to point out that "uterus massage" is such a nice, happy, relaxing, soothing term....


AND THEN I AM SHOWN THIS:


Or how about this? A little manual extraction?
I am praying for my own L&D nurse to have tiny, tiny hands...

Overheard in class:

"Why can't I do IV pushes as an RN?"

"You can, you just need the certification. It's a short inservice."

"Well, what's the point of being an RN if I have to get certified after?"

______________________________________


This was one of the students who was profoundly baffled by the concept of IV infusion.

I hate to break it to her but if she resists ANY competency training beyond the basic BScN she's going to find her career path pretty, uh, nonexistent.

I find it interesting how I've moved beyond focusing on specific skills of care and started "big picturing" a LOT more. Is that by design? Is this a Third Year goal? Or am I just so annoyed with how small-minded some of my classmates seem that I am focused on the overall concept of nursing to give myself strength to make it through another round of microcosmical questions?

Or maybe I'm just going about this all wrong.

Up here in the Northern Wastelands, we celebrated Turkey Day by eating steak and ham.

In keeping with post-secondary tradition, this holiday has been spent hunched over a pile of books trying to come up with a term paper for my N370 class.

The topics were assigned, and fairly uninteresting to me. So far, I have it narrowed down to 2 topics, which are very similar but *slightly* different:

A) According to King’s theory of Goal Attainment, the nurse and the client interact purposefully to set mutually agreed upon goals (King, 1992). Discuss pertinent barriers and potential strengths to mutual goal setting when a patient/family is coping with an acute alteration in health (of your choosing) and develop appropriate therapeutic nursing measures. Your paper should provide specific examples of nursing care to support your discussion as well as demonstrate a clear understanding of King’s concept of mutual goal setting.

B) Present an argument supporting two (2) strengths and two (2) limitations of the registered nurse utilizing King’s theory of Goal Attainment to guide nursing care in the acute care setting. Support your argument utilizing specific examples of patient/family experiences and nursing care/interventions related to a specific acute health alteration (of your choice).

The health alteration I am choosing is Acute Renal Failure, more recently known as Acute Kidney Injury. Even though there isn't a whole lot of nursing-specific information on it (compared to, say, burns), I have some interest in the topic for a couple of reasons. My g-ma has Type 1 DM and has recently been diagnosed with <30% renal function. Even though hers is more of a chronic renal failure, I need to do an acute illness and I figure there will probably be some similarities that I can draw on for those (ever more frequent) times that my family presses me for medical information. My second reason is that ARF/AKI is seen in about 30% of CCU patients and it has a 50% mortality. If my interest in CCRN continues, it will be a good knowledge resource in the future.

Imogene King was a pretty interesting lady. Never married, she spent her nursing career developing her conceptual theories and she defended them pretty much until she died in 2007. I think.

I'm still not sure what the practical point IS for a nursing theory. It still really, really seems like these Nursing Theorists took some common sense, put it into words, slapped a label on it, and called it a theory. And then it was passed through the ages in nursing school for snurses to cry themselves to sleep over. And then they graduated and made a theory so that they, too, could live on in academia.

Maybe I'm just missing the point. Is there anyone out there who has experience applying models to practice?

Last Friday we had labs again. Yup, still terrified for my eventual L&D rotation. N370 lab was fun, as usual. We were reconstituting meds and piggybacking them onto IV.

My battles with the Alaris pump rage on. I'm sure it's the easiest technology in the world once you get it. I still don't get it, and I blame that on the ABSOLUTELY USELESS simulation that we learned on, and the fact that we 'learned' it in 2008. Before I knew anything about meds or infusions.

So we were learning how to reconstitute powder medications. My lab buddy and I got a handle on that right away. There is a label *ON THE BOTTLE* that says if you add [this much] saline, then you will end up with [this] concentration. Pretty straightforward, no?

Then my lab instructor threw the whole class, save one dyad, for a loop. If you have [this] concentration, how much do you need to draw up to get [dosage in question]?

I.e. if I add 5.6 mL of NS to the bottle, the label tells me that will get me a total of 6 mL at a concentration of 500 mg/mL. How many mL must I draw up to get 2g of the drug?

Derp, 4 mL?

My ENTIRE CLASS was stumped. No really, *stumped*. Then we spent the entire lab going over this (zomg straightforward) concept over and over. I can only facepalm.

Sometimes I wonder if I'm smart enough to be a CCRN. Other times, like this, I feel surprisingly optimistic. ;)

Have a great week all!

Yes, it's official! I have made it past the halfway point of my degree. So far it's been a great start; I have been keeping (mostly) on top of my (incredibly massively huge amount of) readings.

My schedule is kind of light this year due to my attempt to do one class by correspondence, which means a no-group-work win, and my advance credit for the elective.

Don't even get me started on the ethics of elective requirements. I don't see why I should be REQUIRED to take Greek Mythology or its ilk. It's a thousand bucks that I'd sooner keep to pay rent with. Post-secondary cash grab, anyone? Is that even a surprise anymore?

Anyhoo, I am taking a mere 3 (!) courses this term:

• HLST 354: Healthy Populations
• This class is, more or less, HLST 152 all over again! The book is OUTRAGEOUSLY mind numbing. I thought I had a handle on reading dry material. This book is so dry it's practically incendiary. Once you slog through all of the verbosity, though, the content is kind of interesting. Chapter 1, the History of Public Health, will make for some entertaining drunken rambles, I'm sure :)

• NURS 370: Nursing Care of the Acutely Ill Across the Lifespan
• aka "When Bad Things Happen To Basically Good (if you're a humanist) People"
• Unlike 270, this instructor is fun and engaging, and, well, interested in the material

• NURS 372: Nursing Care of Families With Young Children
• I don't think there's ever been a more potent contraceptive than an Obstetrics/L&D class. EVERY SINGLE DAY I am cringing about Something That Could Happen To A Vagina Near Me.
• I don't have any desire to ever be an L&D nurse.**

**This may totally and ironically backfire when I am on my clinical rotation and decide that I have found my calling as an L&D nurse.

Packing a wound. I thought it looked uncomfortably vag-like... lol

I fired off an email to the department for the ACCN certificate, asking when I could theoretically begin some of the coursework.

Their reply: "You would need to be in your final Year (4th year) of your Degree program to take the ACCN courses. You would be able to take some of the theory course prior to graduating."

Okay, so I have a year to consider my options. This is good. I have an ICU theory term and clinical rotation in the coming year, so I can make a more informed decision at that point.

A lady at work yesterday saw me reading my latest textbook for my correspondence class. It's dry stuff, but at the same time interesting. The current chapter is examining paradigms and methods of scientific inquiry. It is making me wonder how on earth I'll ever get to the point that I can identify a knowledge deficit and choose to research something real and relevant. This is something I'm going to have to tackle in a Master's program. I guess that's why they want me to have a year's experience in my specialty before applying. But I digress...

She asked me how much longer I had to go in my program. "2 years!" I cheerfully replied, and then we were both a little surprised at how fast the previous 2 years have gone by. A lot of the ladies at my work are very old-school (I am one of the youngest people there, by like 20 years) and they seem to have a real reverence for my being a student nurse. It's a little unnerving. No matter how much I tell them that I actually don't know anything, they want me to shed light on various medical concerns they have - my office has a LOT of medical concerns. In fact I have been clamouring for them to get an AED there specifically because I work with a lot of overweight older adults.

However I was actually able to provide some good information to a co-worker whose dad was in end-stage cancer, receiving palliative care. He lived in another province. She was pretty distressed and didn't want him to die alone in a hospital bed. I told her to inquire about home care nurses in that area.  A few months later she told me that home care allowed him to die peacefully in his own home with his own family present, and she was very pleased with the supportive environment. I was glad that I had managed to pick up SOME little tidbits from Med-Surg, lol :)

That all of my whining and crying about Stats paid off - I got a B. I have never been so happy to get a B before. I just as easily could have failed that course. I crunched some numbers before I went into the final, in regards to my weighted average. Conservatively, I expected a C. Even ambitious estimates predicted I would get a C+ or B-. I must have ROCKED that final to pull off a B. I am SO THRILLED!

Do you know what this B means?? It's an entrance requirement to the Master's degree. "Must have B in Statistics". So I will NEVER have to take stats AGAIN!!! *promptly forgets about z-scores and regression lines*

I also got a fancy letter in the mail in calligraphy type from the Faculty of Nursing (very professional, thanks) congratulating me on First Class Standing for this past year. Not much to brag about considering all my peers' Facebook statii reading "So-and-so made Dean's List!"...

Oh well. It is a small victory, and mine own.

Now that Stats is over, I am taking a correspondence class (starting July 1, web-based) to cut down some of my lecture time next fall. However summer is officially a break for us and I technically don't HAVE to do any more school work. I just want to. That class appears to be all papers and I'm quite excited to just go at my own pace for a change, however fast or slow that may be. And follow my own schedule. Big party this weekend? Cool, I'll just schedule my final for another time.

Lord help me, I'm a little excited to be cooped up in a musty library surrounded by nursing research, with no deadlines to keep.

I have a big summer planned. It technically already started. I spent a gorgeous sun-soaked weekend with my boyfriend. We went on a beautiful long bike ride through the park trails and splashed in the fountain to cool off. We then headed out to my friend's lake house and had a great party and lots of time with beers in hand, just loving life.

I am leaving on a 3-week trip to Thailand on July 13. We are going to see and do all kinds of things. I just got my updated passport a few weeks ago. Then, when I come back from Thailand, I'm going to be all ready to move into my fabulous new condo. No, I didn't buy a house. I'm renting this one too. But it's at least a million times nicer and better than the one I've been living in since last September. This current one is mousey (REALLY mousey), moldy, gang-infested, and rife with electrical problems. Not to mention the sketchtastic neighborhood. I can hardly wait to move. In fact I just bought a ton of boxes from U-Haul to get started. So on that note... have a great week everybody!

[Photo Credit]

I'm a pretty good student, I think. I show up to class, I do my projects, I contribute, and I get good grades. I think, on the whole, and unless instructors find my contributions irritating, they like having me around.

That said -

STATISTICS IS KILLING ME!!!!

It's a 5 week course, which I assumed, following the utter exhaustion of clinical this past winter, meant it would be a cakewalk.

This is THE hardest class I have ever taken, and it's not even related to nursing. In fact I don't really think it's applicable at all to nursing, at least not at the depth to which we are learning it. Apparently the faculty agrees as they are phasing out this particular course and creating an 'Applied Statistics' course that teaches students to analyze data using statistics software.

This particular course has me manually crunching numbers utilizing 4 pages of formulas. I am graphing curves, calculating z-scores, difference of means, means of differences, null hypotheses, critical values, confidence intervals, p-values, probabilities, paired differences, regression lines, and chi squares, and losing. my. mind.

I mean, I get it. Nursing does and must rely heavily on research and it's important to understand how that data was analyzed so I can determine whether it's reliable or whatever. But I will NEVER, NEVER, NEVER be given a set of values and asked to determine BY HAND what the margin of error would be for a 10% significance level. Except as the meanest joke ever.

Get a load of these symbols which I am supposed to differentiate between. They all mean something completely different and the same symbols mean different things in different formulas:

A, a, α, B, β, b, C, d, df, E, ∑, ∈, H₀, H₁, k, N, n, σ, p̂, P (A | B), P (x), p-value, ρ, q, R, r², s, S_e², SS_x, t, μ, x̄, x, χ², y, Z

*shudder*

You should see some of the formulas we use. With the simplest calculators you can imagine. This one is particularly spectacular:



I worked hard to ace the midterm and I got a 70. I need 40 on the final to pass the course. C- will give me credit, but the Master's program requires a B in statistics. Which means that unless I ACE this final I will be retaking this course.

Final is tomorrow - it will be over one way or another. Man I hope I never have to see it again. My biggest fear is that I will run out of time on the final like I did on the midterm, and not be able to go back to check my work. I lost a bunch of marks on the midterm due to stupid mistakes that I might have caught on review.

It just takes me soooo long to work through the questions. There were 12 questions in my last assignment. That took me at least 6 hours to do. I have 9 questions on the final, and 3 hours to do them...

Every mark on the final is worth 1/2 a percentage of my final grade. No pressure, right?

AAAaaaahhhhhhhh

*Cough* *wheeze*

That’s me blowing the dust off this URL.

Wow, people, can you believe it’s already almost April? I’m almost halfway to being a registered nurse!

Geez, I think there’s an echo, it’s so empty in here :)

You may be wondering why I took an extended break from blogging. The truth, friends, is that my life is Just That Busy, and blogging was an additional stress that I decided to avoid for a while. So instead of apologizing and making promises for content that I can’t keep, I’ll do a brief summary of this past few months and then I’ll get to the rant that brought me back to my blog. I hope you are all coping well with your equally busy lives :)

The fall term from September to December was probably one of the most intense I’ll face in school, content-wise. The term was packed with classes including Patho, Health Assessment, Nursing 270, Mental Health, and 2 labs per week. There was also Pharm on the table but I was smart in taking it last summer because that was a very memorization-intensive class. In all I was taking 17 credit-hours in the term.

My most enjoyable classes were Health Assessment and Mental Health. HA was very cool because it involved all the classical assessment techniques including inspection, percussion, palpation, and auscultation. Our instructor was a seasoned ER nurse who had a ton of stories to back up all body system assessments. She was especially great because she had that snarky, straight-to-the-point way of talking that made things humorous and memorable. Head-to-toe assessments are still tough for me though; I think that’s one of those things you need years to really master.

Mental Health was also an interesting class. I won’t lie – I really wasn’t sure if I like the idea of being a psych nurse. However the instructor for the course is an AMAZING RN who specialized in mental health. The thing that really got me about her was how intelligent she was. She can talk about anything with anybody and be very clear and direct about it. She can argue circles around you. There was no slacking in her class because she would not be duped by a half-assed effort. She saw right through work that was done the night before – she knew exactly how much effort everyone had put in, and graded you accordingly.

We had to split into teams to do a debate in that class. Would you believe that people were actually clamouring to have me as their partner? Do I strike you as fiesty? lol! The debate was great. Our topic was burnout - nurses' fault or system's fault? Our position was assigned and we had to argue that burnout WAS the fault of the nurse and not the system. Tricky! Everyone said we did a great job though.

Patho was a pain in my ass because I absolutely hated the instructor’s teaching style. Call me too picky but I (still) STRONGLY believe that the instructors I am paying good money to teach me a class should be doing that field as a career. At the very least I want a Biology graduate teaching me a class about biology. Unfortunately I had a super-sweet, absolutely batshit crazy RN teaching Patho. I don’t know why. She wasn’t the expert in anything about Patho and any question just dumbfounded her. She didn’t even design the course. She was teaching one developed by someone else. I am a very linear learner. Show me how one theory leads to another and I will be right there with you. But she was so scatterbrained that she would jump around between body systems and the majority of the class would just stare at her. In all honesty, I didn’t go to her lectures much – they confused the hell out of me. My Patho knowledge was almost completely self-taught from a very, very good textbook** (see below for my advice on textbooks!)

Nursing – oh, boy. This was the second-year “meat and potatoes” class about (you guessed it) nursing. Now, after a lot of time spent on allnurses.com browsing the Student Forum, I think how my school handles the nursing content of nursing school is very different from how other schools do it, particularly those in the US. Other schools have classes geared towards different specialties. Medicine, Orthopaedics, OR, OB, CCU... I think that would be incredibly useful for getting a SOLID base of knowledge for each specialty before rotating into one during clinicals. Unfortunately my school believes that all you need to know about nursing is how to think like a nurse and the rest will just come naturally.

I disagree.

I postulate that in order to think like a nurse, I need to understand where nurses are basing their clinical judgement, and to do that I need to have a solid knowledge base.

Yes, you can teach me about ADPIE and NANDA and NIC and NOC, but all of those things are pretty much meaningless without knowing where patients are supposed to be baselining and what interventions we have available, and – most importantly – WHY we would use them!

So what did we learn in NURS 270? Well, several (SEVERAL) classes on meaningless hippy jargon about the power of caring and crap like that. Pardon my language and perhaps condescending attitude but either you care about people or you don’t – talking about such nebulous concepts as “the power of caring” and different ways of "living the patient experience" is a waste of time for everyone. The people who do care already have the intuition needed, and the people who don’t care aren’t coming to class. Even if they were, it’s not something you can teach in a classroom. I think if someone seems like they can’t or won’t care about a patient, it’s probably better addressed in a one-on-one clinical evaluation. The vast majority of us found all of the exercises to be common sense. IMO, the people who really needed their viewpoint adjusted were skipping class anyway.

We learned absolutely nothing about any of the nursing specialties. No baselines for knowledge, whatsoever... just whatever we gleaned from Patho and Pharm and lab time. I most definitely felt like this inhibited my learning experience in clinicals for this term because I had to learn everything on the fly. Which was in itself a good skill to learn, truthfully.

So, anyway, the Fall term was all classroom time. Some more useful than others. Some instructors I loved, some I loathed. Some great learning opportunities, and a whole lot of self-teaching after class in the library. I definitely learned a lot! More than I would have believed could ever fit in this skull of mine ;)

Well, I think that summarizes the Fall semester. I do have a lot to say about this term as well but I’ll make another post about it.

If you’re a new reader, welcome, and if you’ve stuck with me since my last post... wow, I appreciate you :)