While at work over the last few days, I have spent a few hours browsing iTunes U for various Nursing vodcasts. It's really, really fascinating to see how other schools teach their students. For those who don't know, iTunes U provides a medium for educational institutions to post video or audio feeds of their lectures, and they are free to view for anyone who has iTunes (also free). There are lectures on every subject you can think of. I love to just browse different topics and learn. The other day I watched a vodcast about Relativity. For no real reason, just because I could. [Photo Credit]

My school, new as it is, was built as a 'smart' institution with microphone hookups and live feed capabilities in pretty well every classroom. It doesn't currently participate in iTunes U, however. I think my school is concerned over privacy issues and intellectual property. I have this dream that instead of burying their heads in the sand and choosing not to address the promise of global education, our nursing faculty would embrace the accessibility of information and begin to publish some of our classes. (Check out the iTunes U how-to guide!)

I find it very exciting to think of how this technology could be utilized by the nursing community at large. For curious students (or would-be students!) like me, it is an easily accessible look at various aspects of nursing and it can introduce us to all kinds of specialties that we may not have known about. How awesome would it be to browse to a central organization website like the CNA, and be able to find and view lecture classes for specialties that you might be interested in? I am thinking specifically of the CCU certification I am interested in, or other advanced Post-RN coursework available at my university like Advanced Wound Care. You could utilize other schools' lectures to supplement your own - maybe to get a different point of view on difficult concepts, or to expand on something that you found interesting. You could even see how other student nurses in the world are learning.

On a larger scale, this could be utilized as refresher courses for distance learning or a video log of the entire class you took. I, for one, would LOVE a v-library of my lectures. I would pay extra to have a permanent record of the classes I take. I feel like I only ever take away about 30% of the information from any given lecture, because really, there's just way too much information assaulting my neurons at once. And how great would a v-library be for studying??

Imagine being an outpost nurse who is planning a community-scale intervention in diabetes management. Sure, you can spend hours and hours digging up relevant research (and you probably will), but imagine if you could visit the site for The Diabetes Nursing Interest Group and find podcasts for the most up-to-date EBP based on current research.

In short, you could find out how other nurses are nursing, straight from the specialty's organization. They could put out quarterly updates with new information or the latest in EBP.

How is this different from the newsletters or PDF publications that are already sent out, you ask?

The big differences would be accessibility - anyone could view this information, not just the organization and not just nurses (!) - and method of delivery.

Reading through a 37-page PDF is a lot more tedious and abstract than viewing a 10-minute video showing the latest in nursing interventions. How much easier is it to learn when you can actually watch a video of a nurse interacting with a patient, instead of just reading about it? Things that are best shown visually with an accompanying explanation, like new methods for IM injections or crisis interventions.

The possibilities are massive. This could theoretically be on a huge scale, with global involvement. Ideally, having this kind of information available from such reputable sources (CNA, PHAC, and NIH, to name a few) in such an incredibly accessible format - over 200 million iPods sold, worldwide! - could even be utilized to educate and influence public health. Inexpensively... AND "upstream" in that nebulous idea of primary health care.

I believe people are becoming increasingly open to being involved in their own preventive health maintenance (anyone notice how popular the Doctors have become? I laugh every time I see them in their pristine TV scrubs). I think that good, reliable information is hard to come by. Google any medical question and you're going to get 2,000 results from Yahoo! Answers or wrongdiagnosis.com. The world is ripe for reliable information at our fingertips. This kind of health information is mostly an untapped market, IMO. I find this all very very exciting.

I guess what I'm trying to say is that post secondary education and research isn't off in some ivory tower (or imposing brick-and-ivy academia) anymore. You don't have to get periodicals from the library to keep up with the current knowledge base. Any layperson can experience the post-secondary environment for free via one of the most accessible mediums to have ever been invented, short of the Internet itself. The information found there is (presumably) based on the most up-to-date resources available.

While I am waiting for the world to catch up to my ramblings, here are a few nursing-related lecture podcasts on iTunes U that I have subscribed to. I haven't watched them all, yet, but they're pretty much everything that I could find that was published from a School of Nursing. Please leave links to your favorite nursing podcasts in the comments and I'll update them here! Happy watching/listening :)

Acute Adult Nursing
Adult Health III
Clinical Skills for Student Child Health Nurses
College of Nursing Lectures - Video
Diabetes Care
NURS 083A: Pediatric Nursing
Nursing Informatics Program
Nursing Skills: Techniques for Sub Cutaneous and Intra Muscular Injections
Penn Nursing: Care to Change the World
Pharmacology for Future Nurses
Nursing-Psychology 342
The School of Nursing - Art of Bedside Care
The School of Nursing - NCLEX Review
Surgery ICU Rounds Podcast
Yale Health & Medicine

A great post brought to you by Raspberry Stethoscope! I have been reading her blog for over 2 years now. She has a zillion great resources for nursing students but she is a staff ICU nurse now in Florida!

http://www.raspberrystethoscope.com/2010/06/what-happens-during-half-of-my-day.html

0612 Begin head to toe assessment: listen to lungs, heart, bowels, check pulses—radial and pedal. If pt alert, ask if they have pain, how they slept, follow-up with concerns. If ventilated and sedated, make note of ventilator settings, suction the patient if needed, tidy up the room (!!), check pupils. Zero any alines, cvp’s, ScVO2 monitors, check alarms on monitor, adjust to personal setting. Check room, make sure ambu bag, enough flushes in the drawers/make sure room is stocked for a code! 

0620 if patient or family does not need anything, such as blanket, ice, bed pan, water, etc. then begin   to chart assessment on flow sheet (approx 3 pages). Go through chart and if not already done, update special treatment pages, education, graphics for IV access, treatment/plan of care, remove 234234 extra papers that do not belong in the nurse’s chart, reprint patient id stickers.

0630 Onto patient #2… chart 0600 vital signs, including: blood pressure, HR, Rhythm, sats and O2 %, temperature, RASS scale, dump urine for the hour and note milliliters.

0632 Begin head to toe assessment: listen to lungs, heart, bowels, check pulses—radial and pedal. If pt alert, ask if they have pain, how they slept, follow-up with concerns. If ventilated and sedated, make note of ventilator settings, suction the patient if needed, tidy up the room (!!), check pupils. Zero any alines, cvp’s, ScVO2 monitors, check alarms on monitor, adjust to personal setting. Check room, make sure ambu bag, enough flushes in the drawers/make sure room is stocked for a code!

I got a callback today from the UNE position that I applied for two months ago!! They left me a voicemail acknowledging that it was already well into the summer months for college students and asked if I was still interested. They wanted to shortlist me.

YAY

I called back and told her that I was going away for 3 weeks during the summer but otherwise YES I was still interested, especially in an ongoing basis.

Here's hoping!!!!!

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 don't know if you guys have looked. I'm SURE you have. I'm sure you're all just as concerned as I am about where the hell you're going to work once you've got that shiny degree on your wall. I'm only halfway done and I'm already panicking!

My *ideal* career path would be a year or two in Med-Surg, while building foundational skills, and then to grow into a CCU nurse. I'm not 100% sure if CCU is ultimately the kind of nurse I'd like to be (who can be that sure, anyway?) but a lot of things about it are appealing to me.

Certainly, one of the best days I've had in clinical was when one of my patients had higher acuity and I had to manage him, his family, and my interactions with the rest of the care team very diplomatically and with as much knowledge as I had. Everything that came up with his care made me ask myself questions. I spent my breaks researching. I loved every second of it, even though it was a very difficult time for him and his family. One of the weird things about nursing, I guess - some of your best days are some of your patients' worst.

My career path has always seemed pretty workable. Get a job in something basic, then specialize, while continuing my education. Ever since I realized that I liked learning, I haven't wanted to stop. Sure, some days I wish I was done school so I could have time to myself and actually have a life, but on the whole I've loved every second of it. Stop at my BScN? Hell no.

Unfortunately, with job prospects dwindling and having heard nothing back from the internship I applied for, I'm starting to actually get a little spooked. Our schools keep churning out new grads and I haven't found a SINGLE RN job posting that didn't require at 1 year experience. In fact I haven't found a single RN posting that was in anything other than a specialty.

The job market tanked in the last two years. One hopes it will float again in the next two.

However, in case it doesn't (or in case any market improvement is only temporary) I am considering pursuing this certification on a part-time basis next year as a senior student. I am hoping it will give me a leg up over the ~150 nurses also graduating with me. There are some theory components but most importantly, there is a 210-hour clinical component.

AKA networking opportunities.

Eventually I want to obtain my Critical Care Nursing certification through the CNA.

Alphabet soup? As long as it brings job security and a paycheck, I don't mind one bit :)

[photo credit]

I had some things I wanted to talk about today but Blogger was down all afternoon. I flirted with the idea of exporting to Wordpress like so many others did. Then it looked like I would have to pay to host my own domain in order to upload my page design.... not to mention all the other headaches involved with changing blog hosts.

Then I thought some more about the future of undergradRN. This blog's purpose has always been to follow my journey through nursing school and allow me to share resources and connect with you like-minded people. Often it has been a therapeutic diary for me. Sometimes I cobble together some resources that people seem to utilize.

After dreaming a little bigger and then weighing the idea of keeping up a higher-traffic site along with the quasi-terror I have about being outed and no longer anonymous, I decided that I am happy with my little slice of the blogosphere. UndergradRN will continue to be hosted right here at undergradrn.blogspot.com.

That said - shape up, Blogger, or I am shopping elsewhere ;)

This past 6 months (wow...6 months!) since the whirlwind of back-to-back clinical, nonstop patient research, papers, drug profiles, and my actual paid work has made me exhausted (see right!), crazy, happy, angry, frustrated beyond belief, and very nearly completely burned out. I didn't have much left to give to work, or to clinical, to my instructors, or most importantly to my patients from my inner self. I had no time to reflect on lessons I'd learned or to prepare adequately for the next 16 hour day. It was just a feeling of sinking... sinking... sinking... and I'd gasp for breath and paddle harder.

Now that it's over I feel practically weightless. You mean... I can just GO HOME after a full shift at work? GO HOME and NOT research things, not unless I actually want to? I can read for PLEASURE? I can reactivate my Warcraft subscription?

What is this "free time" you speak of? I literally can't remember the last time I just sat around and kept the couch warm.

But it's so profound to take a step back and see the whole picture. To get OFF of the myopic hamster wheel called "How To Fit Everything Into 24 Hours".... to get out of that mindset and actually take a good look at who I am becoming, where I've been, and where I'm going.

This is exactly why I blog.

It's been 8 years since I left high school. 8 years ago, I felt like getting married and having babies was who I was meant to be. I'd earned my diploma, but barely (which was my own fault) and college just seemed out of reach. I toyed with the idea of Nursing but my grades were nowhere close. Still, I checked out a few options including an information night at the University (then-college) which I now attend. I can still remember the feeling of awe and privilege I had, being in that classroom, meeting the Nursing faculty. My heart leapt out of my chest as my sneakers squeaked down the polished halls on that seemingly huge campus. Registrar? Student Services? A bookstore? A cafeteria with actual franchises? Wow! But it was not to be... I dared hope that night about the person I could be, but then firmly squashed that dream by saying "school is not for me".

I went into fulltime/casual home care for 5 years. The more I did it, the more I loved it. I was privileged to meet caring families who were strong advocates for their profoundly disabled relatives. My town was relatively forward-thinking, for small-town agricultural Alberta, and taught me a lot (a LOT) about patient rights and respect, and seeing the patient through the family context (a la McGill Model). Home care challenged me and inspired me to think bigger. To consider new options.

I took some time for myself and travelled, on my own, like Lesley from Glitter Scrubs recently did (welcome back, btw!). I found out SO MUCH about myself and who I am. I worked closely with horses every day. I am not much of a 'New Age'-er but if there is such a thing as a spirit animal, mine has 4 hooves and a big heart. Horses are such sensitive creatures. They respond intuitively to minute changes in your own body language. They mirror your actions (some might say your attitude), and if you learn to be sensitive too, the resulting partnership can blow your mind. They taught me so much about being gentle, deliberate, and conscious of my actions.

In fact, I found that the sensitivity of horses paralleled the sensitivity of the developmentally disabled people I'd come to love in home care. Both were reflections of myself, in a certain way. Both required a careful balance of guidance, understanding, and flexibility from me for a harmonious, growth-focused relationship.

Realizing this, as I spent each evening unwinding by the sea with no one to talk to but the fresh coastal wind and old stone cairns, I knew that in my heart of hearts I was led to care about people and to care for them.

I had this attitude when I was accepted into my first college program - a police officer accreditation diploma. I know who I was and what I wanted. When my favorite professor, a working Staff Sergeant with the municipal police force, said that the Force needed less brawns and more compassion, I jumped for joy inside. Looking around me, however, I saw a batch of barely-graduated-high-school small town attitudes like the one I worked so hard to escape. I was drowning in that toxic environment.

After the whole art school debacle and making the conscious decision to throw caution to the wind and pursue Nursing - my actual heart's desire, all along - it just felt SO RIGHT. Even busting my ass upgrading my marks with would-be nurses failing and dropping out all around me, and the Upgrading Advisor telling me I had a snowball's chance in hell of getting accepted, I relished the odds because it was a struggle for something that was absolutely where I was meant to be.

Two years ago last May, I went to the Spring orientation seminar and crossed the inspiring halls of my newly-built campus for the first time. I can't tell you how that felt. I was excited and terrified and most of all profoundly amazed that I could be so lucky. Privileged - there's that word again.

Well, those of you who have stuck with me since that first blog post in February of 2008 know that nursing school has been a whirlwind with its ups and downs. Most of the time I feel like I can't even catch my breath. Nursing school has pushed my perceived limits of exhaustion, motivation, and passion for learning. Every day that I was made to think harder and more abstractly than I thought I could, I wondered how much more my poor brain could think.

But not once, never once have I doubted my reasons for being there.

I am still, 24 blood-sweat-tears months later, in love with my chosen profession.

Of course, not doubting my reasons for being there isn't quite the same as actively APPRECIATING where I am today. I think my sense of appreciation took a back seat to all-night study sessions and 3 AM paper marathons and 1,000 page textbooks.

So today I give thanks for those times of struggle and bouts of madness as well as the profound moments of patient care that I have been, yes, privileged to experience in the lives of those I have pledged in my heart to care for.

Did that sound sappy? It was honest.

Wow, I can't believe it. I was up until midnight studying last night. I was using some old practice exams and several of my friends called me up in disbelief because the questions were SO TRICKY!! I finally crashed and then woke up at 4 AM in a panic (after dreaming about variables, yippee) and studied some more. Eventually at 6:30 AM I passed out on my notes for an hour, worked through a few more notes, and then went to write the final.

I was SO STRESSED. I was pale and shaky (not helped by my lack of sleep, I'm sure), and just about in tears before I went in to write the exam. I mellowed out to Aqueous Transmission on repeat while en route to school.

Oddity of the week: While I was walking up to the door, I spotted a strange basket thing on the sidewalk. I got closer to it - it was a baby's carseat. With a baby in it.

I looked around and there was NO ONE in sight.

Just... a baby.

This was about 6 minutes until my test.

I zoomed into the school office and told the bewildered girl that she had to go and do something with the orphan on the sidewalk because OMG I had a final to write.

Last I saw of her, she went out to try and figure out where the baby came from.

The sidewalk was parallel to a small parking dropoff for a daycare so my assumption is someone loaded up the car and forgot the baby...... :S

ANYWAY, I went in to write the exam, and to my IMMENSE RELIEF it wasn't impossible. I mean, it sure as hell wasn't easy. It was still one of the hardest tests I've ever written.... but I was able to answer all of the questions (right or wrong, at least they had an answer!) and I finished in time with about 10 minutes to review my work.

Big shoutout to my amazing man who hooked me up with his copy of the textbook, study solutions guide (infinitely useful!!), and even a full-featured calculator that shaved precious minutes off of my calculations and showed the whole entry line so I could easily double check my inputs!! Better yet when he stayed up till midnight to help me study and offered to come over before work this morning too <3

Immediately after handing it in, I burst into song and we went out to relish the gorgeous afternoon with beers and pub food on a restaurant patio. Management was kind enough to give us a free round of "Crispy Crunch" shots. Tasty!

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