Back at it! School, Politics, Nursing, etc...

SCHOOL
------------------
Yes, it is back to school time. I'm taking Nursing Leadership, Professional Seminar III (Legal and Professional Issues), and Transcultural Healthcare (the one I dropped part way through last semester). It's shaping up to be an okay semester. It's the last semester before graduation, so how could it not be good!
Last semester was sort of rough due to some dramatics between our class and a new professor. I'll just say it wasn't a great start for her at IPFW. She really seems to have a heart for CHN, but the way our class sessions were organized and executed made it difficult to know what to expect on the tests. It was sort of a trainwreck. Despite the turbulence, I came out with an A in the class, so it's all good.
I'm recomitted to staying organized this semester. I say that pretty much every semester and then end up getting off track halfway through, but I think working in the ICU has drastically improved my organizational abilities. I invested in a very sleek, black planner that outlines every day in 2009 down to the very hour. I have actually been using it and taking it to class and work, and so far all is well.

POLITICS
-----------
Well, prepare to share the wealth, my friends. America has opted for "change" and is being rewarded for it by getting an executive branch with a lot of old Clinton-administration folks and other Democrat party fixtures. Also, DR. SANJAY GUPTA HAS BEEN TAPPED TO BE THE NEXT SURGEON GENERAL? REALLY? Maybe Oprah needs a position in the State Department. I guess Dr. Gupta is a neurosurgeon and all that, and I'm not really clued in to the Surgeon General's job description, but I'm guessing that there are probably docs out there doing more substantive things than cute little news segments on CNN, that are probably better candidates for the job than ol' Sanjay. I guess it's sort of a symbol of part of the reason I'm not crazy about this administration. Barack Obama is sort of a pop star in my eyes. Yes, I realize the fact that being popular is sort of the way a politician succeeds in a Democracy, but I feel like a lot of people like Obama for the wrong reasons. Anyway, I hope Barack and Sanjay both do a great job for America and our health care system.

Anyway, it's not like we have a great alternative to Obama right now. The Republian party has abandoned conservatism for a sort of (cliche, I know) fascism. I'm not sure what else to call strong support for the welfare state mixed with strong nationalism and 'interventionalist' foreign policy. The Republicans need to get back to a more libertarian conservatism along the lines of Ron Paul or Berry Goldwater. They would have to figure out how to market it, but without standing for truly conservative principles, the Republicans will just languish in their current invertebrate state.

On a side note, one thing that gets me about the Democratic Party, is how they can feel like they're civil libertarians while supporting socialist economic policies. How can you be free when the state is footing your bills? The government controls the schools, so they control what our children learn. When the government pays for your healthcare, they will tell you how to live. Both parties are chipping away at our freedom in their own ways. They make it seem good and necessary, but in the end, they are insidiously stripping us of our liberties. The patriot act from one side, nationalized health care from the other. We need to recommit ourselves to proteting our freedoms in this country.

NURSING
-----------
Well, I've been in the STICU for a year now! It really doesn't seem that long... I've learned so much, but it's just the tip of the iceberg. So far I enjoy caring for septic and neuro patients the most, but I am really interested in critically ill patients in general.
My practice is evolving every day. Between work and school, I am going through a lot of growth as a nurse. Every time I show up on the unit, I learn some new aspect of how a certain presentation is medically managed, or I see some unique way that a client psychosoially adapts to their new circumstances. After each shift I am better able to anticipate the needs of my future patients. School is also augmenting my care by teaching me to apply nursing theory and research in new ways. Community health nursing taught me how to better integrate my patients' cultural backgroud into my care, and how to assess families as clients. It also improved the case management side of my practice. I look forward to learning more about the legal aspects of nursing this semester as well as how to improve my nursing leadership abilities.
Basically, I'm loving my job right now, despite the usual complaints. Staffing, pay, prestige, all the things that nurses usually don't get! I love the nursing, it's all the things that get in the way of my practice that get me down.

ETC...
----------
Are Angie, Anika, and I moving to Albion? Probably not. Everything was going swimmingly until we couldn't get the loan. The loan officer at the bank said he has never seen conditions like this. Our credit is pretty darn good, and no one really expected us to have difficutly getting financed, but that's life. We're still negotiating with realtors, but it looks like it's probably not going to happen. Sorry!

Music: I don't get to practice/play enough right now, but summer's coming! Plus, I bought a glockenspiel! Well, actually it's a student bell keyboard set, but it's a lot like a glockenspiel! THE WELCOME WAGON IS THE SWEETEST MUSICAL GROUP SINCE SUFJAN STEVENS! Okay, that's not very long ago, but they're very awesome. They're on the asthmatic kitty label and Sufjan Stevens produced their music. The group consists of a Brooklyn preacher and his wife singing music in the style of traditional Christian hymns with Mr. Stevens' signature sounds to back them up. It's folky and it sort of reminds me of the 150 year old Church in the middle of a cornfield that I used to go to as a kid (that's a good thing).

Movies: I guess a lot of people didn't like it, but Angie and I thoroughly enjoyed the movie, Seven Pounds starring Will Smith. Yeah, it was extremely emotional and improbable, but I personally enjoyed the darkness, the psychology, and the overall feel of the film. Plus, it has a very endearing love story or some such girly thing like that.....

Oh yeah, it's X-TREMELY cold outside.

I'm done now.

Ok.........lahoma

So, I played about 36 measures of moderate tempo bluegrass banjo for my old high school this weekend. They're doing a pretty good production of Oklahoma. It's been fun seeing how everything is pretty much the same, just with different people. Things really don't change that much...

Other than that, it's business as usual. I dropped my transcultural health care class due to being busy as a cracker, but I'll take in next semester. I should still graduate at the end of this academic year if I can test out of a couple of classes (I should be able to!) I've been spending lots of time with the fam. I've been working and going to school as well. On a happy note, we may go to Europe during Winter Break. Brrr..... Oh well, we can't afford to go in the summer!

Sometimes it's depressing to hear what people think of nursing. I try to avoid the subject with those outside the field because people are usually unintentionally insulting or patronizing. I think that much of what people believe about nursing stems from outdated feelings about class and gender. Nursing carries the stigma of not only being a 'technical' rather than academic field (which is only partly true), but also as 'women's work'. It seems that many people carry around this faulty, inherited idea of nurses being simple, but caring as they dutifully scrub bedpans and hand out pills. I'm not trying to say that undergraduate nurses are medical experts (some advanced practice nurses do have very advanced medical knowledge), but it just seems to me that there is a widespread misunderstanding of the profession.

My blog is now linked with facebook, too. Yay?

"You're doin' fine, Oklahoma.... O.K.!"

Back to school....

Well, it is that time again....... Back for another wonderful semester of RN-BSN completion. More classes that aren't quite 100% useless, even though they feel like it. I think since I work in an area that is so centered on my clients' medical problems, I lose sight of all that nursing really is. Anything that's not pathophysiology seem pointless to me as an ICU nurse. Sure we deal with psychosocial stuff, but we also have chaplains, case workers, social workers, patient advocates, and loads of other professionals who are better equipped to handle these issues than we are. Betty Neuman said that nurses should be holistic in their care, assessing and intervening not only on a physical level, but also on psychological, spiritual, sociocultural, and various other less tangible levels, but when someone is septic or in respiratory failure or whatever, their sociocultural needs (important as they are) don't seem to concern us as much as their need not to sink deeper into distributive shock. Maybe it's just me! It may really be a nursing problem, but it seems that we barely have the time and staffing to keep some of our patients healthy/alive.

Anyway, here's a rundown of my classes....

COMMUNITY/PUBLIC HEALTH NURSING (5 cr.)

I think that I'll either be working with a school nurse or in a community free clinic. I'm hoping this experience will broaden my view of nursing. As a future NP, I hope this will also show me some possible career tracks. This is my first clinical course since Spring of 2007, so I'm really looking forward to doing my first clinical as an RN.

HISTORY OF ROCK MUSIC (3 cr.)

Oh yeah... let's hear it for area IV general education! It was either this or Victorian Novels or something like that. I honestly wanted to take History of Jazz, but it wasn't available... It's a music class, so it focuses on the musical development of rock. How much sweeter does it get?

TRANSCULTURAL HEALTHCARE (3 cr.)

Lesson One: Don't stereotype people
Lessons Two through Twenty: Various accepted stereotypes about the peoples of the world

DISASTER NURSING (1 cr.)

The title of my autobiography? No, silly, it's the title of the one credit hour weekend course I'm taking in September. I hear it's more of a pain than it ought to be.

That's right suckah, 12 credit hours. Did I mention I'm also working 36 hours per week in a challanging setting that require 4-12 hours on call per month with madatory upstaffing? Or that my wife is also taking 12 credit hours? Or that I have a four month old? Yeah, it's going to be busy. No, I will not get to eat a meal at home during the week. Fortunately we've hired my lovely 20 (soon to be 21) year old sister to watch our child. Unfortunately, I've had to drop my guitar lessons.... That made me sad, but there was really no other way. On a happy note, the federal government is paying me almost $600 to go to school this semester. That number will probably go up after my wife gets her Financial Aid package through. If I can do 12 credit hours this semester and 11 credit hours next semester, then I will get my bachelor's degree in the spring.... THEN ON TO NP SCHOOL! Yes, it's true, I'm pretty excited about that.

ST elevation

Hey, not all ST elevation is indicative of acute MI. Who knew? Well, I guess I knew it could also be pericarditis, but still... If the ST segment is in the shape of a frown, then your patient should be sad because they are probably having an MI. If it is in the shape of a smile, then be happy! It could be either pericarditis or benign repolarization. Trust me. I am a very trusty source.

I worked 16 hours today and I feel more entitled to complain than ever. I will make it short: I am tired and my feet hurt.

I was in Neuro ICU again today! Woot. Good times for all! I was managing ICP though, which is usually a busy process. Fortunately no Mannitol today (way too many labs with that one), but I was pushing sedation hourly. Oh the tedium. Not really, I like managing ICP, it is a good chance for a nurse to use discretion and make a real difference.

A few random goals for my work days:
-Patient has better sounding lungs when I leave than when I came
-Bond with the family
-Finish report before 1530
-Leave the patient and the room cleaner than I found them
-Lots of other groovy things


Fact: When I see commercials on TV encouraging people to pursue careers in healthcare, I shout at them, "Noooo". I actually think healthcare is very swell. Swell like edema. I wonder how swell ever came to be an adjective that means "great". I am sleepy. Hypnotoxins!

House

Yeah, I like that show a lot. My wonderful wife rented Season 3 today and I'm just starting the second disc.

The Standard Nurse Complaints:

1. They don't give nurses any credit...
- Yeah, it's true they give firefighters more medical competence than they do nurses, but that's standard procedure for TV. There are a ton of important team members in the hospital; it would be impossible to make characters for all of them.

2. The doctors do things they'd never do...
- I can just see a big shot doc running a patient through the CT scanner (or performing phlebotomy, etc.). Most of them don't even know how to use our IV pumps, but again it's probably a matter of getting as much time as possible with the main characters of the show.


Yeah, I'm a crybaby. Oh well. Nursing still has a long way to go. So does televison.

Anyway, I love this show and I will watch it in spite of my complaints!

addendum

I had my first patient die the other day. It was strange. Where a person was, a body lay. I had empathy and compassion for something that occupied that body, something which was striving and had purpose and soul. Then, with the flattening of a line and the quieting of a beat, that something was gone and the body became flesh. Since there was no clergy or physician available at the time, it was left to me to tell the patient's dearest loved ones that this had occured. With compassion, but without pretense, I informed the family that the soul they had cherished was now beyond their reach. Maybe someday, when their living bodies still and become flesh, they will be reunited, but I left that for them to work out. All I knew was that the person I had cared for was now gone and it was up to me to get the flesh off of the bed so the housekeeper could wipe it down and we could put a new body onto it.

When the housekeeper was nearly finished in the room, I noticed a scrap of paper pressed up against the side of a clear trash bag (clear trash bags in a hospital, what a swell idea). In the final hours of life, my patient had scrawled some barely legible message on this sheet. Seeing that handwriting was eerie. There was a bit of my patient's spirit stuck to that page. The symbols on that page weren't just a note, they were the last remnants of that individual's consciousness left in that room. It made me think a lot about the frailty of life and the nature of what we leave behind. In the hospital we have lots of plaques on the walls dedicated to old-timey physicians who were probably big shots back in the day, but to me now they are no different than any other dead person. Life is too short to be prideful, arrogant, and hateful.

Someday your lungs will fill with fluid as your heart loses the capacity to push the blood through your body; your cells will starve and you will die. In the same way, the field laborer, the imbecile, the artist, and the trauma surgeon will all finish their lives. Many will do so with a young nurse standing by, ready to file their paperwork and clear their bed.

Isn't it weird sometimes how the more you experience, the less you know?

"People are just people; people are just people like you", "and everyone must breathe until their dying breath". (Yeah, I'm kind of a Regina Spektor nut lately.)

yeah, i pretty much forgot about this thing...

Okay, I haven't written here in a reeeaaallly long time. Basically, I've had a very busy summer.

May

6th- Anika was born! Off work for a couple weeks.
9th- Finished the semester w/ A's and B's after some rescheduled finals
20th- back to work...

June

First two weeks- BLC Camp Nurse! Good times. Scrapes, sprains, and a suprising amount of Otitis Media. Also earned my Pediatric Advanced Life Support certification.

14th- 1 year anniversary of my RN licensure

20th- officially off of orientation @ work! I became an independent ICU nurse (oxymoron... no ICU nurse is independent; it is a team effort. that sounds retarded, but it's true!).


July

10th- went with Angie to Indy for the weekend; left Anika with mom and dad. I gained seven pounds in four days! proud to say, it's all off (it was all water and *ahem* 'bowel' weight, i guess).

14th- back to guitar lessons after missing approximately one whole month of them!


so I'm back. i hope i remember to write more. i'll give you a brief run down of where I am with my life right now.

WORK

yeah, it's nice not to have to work with a preceptor any more. i get my own assignments now. i've been almost exclusively assigned to the neuro section of the STICU, which is fine with me because I love neurology and because it's intentionally quiet back there for our SAH (subarachnoid hemorrhage) patients. i'm not really antisocial, but perhaps a little schizoid/paranoid in some social situations (namely school and work; in four years at IPFW, I haven't made a single close friend!). I do fine with patients and their families, but with my co-workers I just am really shy. anyway, the nursing in 'the unit' is cool and complex; i have learned a ton! I'm working on my Advanced Cardiovascular Life Support Certification now. Good times. I'll then take my Trauma Nursing Core Class next week. Good times x 2. I had to save my patient's life from some family practice residents the other day. They were literally writing the order to withdraw all care from this individual until I dragged his family in there and explained to them exactly what was going on. They had been completely misinformed. It was a disaster. Anyway, work is quite good.

SCHOOL

starts in August.......

MUSIC

I finished my first book of classical guitar technique (shearer's book). I'm now on a book of novice/intermediate arrangements of classic guitar pieces (royal conservatory of music's guitar series 2). It's first/second position stuff in the keys of C, G, and D for the most part. I love it!


ETC.

sis is still in Yellowstone! hurry up and get back here...

I love being a dad. It rules my world.

Nursing v. Medicine

Nursing is not independent of medicine. It is a limited application of it. That's not what my teachers say, but that's what I find @ work. A Doctor can do a nurse's job, but not vice versa. Am I missing something?

16 hours, drudgery, and Indianapolis

I worked my first 16 hour shift at Parkview last night. I stayed from 1500-0745. It wasn't really that bad. The only real difference for me was that I was noticeably sleepier than usual at the end of the shift. I went home and slept until like 1430. Also, I found out that I will work from 7p-7a, two days per week on the new unit. Very cool. The bad thing about night shift is that there is a lot of lame work we have to do. It's stuff that normally unit clerks would do (note: unit clerks rule!, but some of the stuff they have to do is not so awesome) like put rounding reports in the charts and enter all of our own orders. It's alright though, it's nice to get everything in order for day shift.

I love the internet, I HATE INTERNET CLASSES! It's like, I like bikes, but if I had to ride one for too long (like the amount of time I have to spend checking on these idiot classes) , I would vomit blood.

Angie and I are going to Indianapolis on Friday and staying two nights! We're going to either a dinner theater or symphony orchestra on Friday night, seeing Indy on Saturday, and going to a Pacers game on Saturday night. Plus, we're 21! We can go anywhere! It will rule.

Music, work, and a piano

I'm probably going to take on a music minor with guitar as my instrument. It's somewhat intimidating, but I can do it! It's going to take me probably two extra semesters to get my bachelor's degree, but you know. I just worked out my scheduling for the spring semester. Community health nursing w/ a clinical, IV therapy (kind of below my paygrade at this point, but it couldn't hurt), Disaster Nursing (one weekend), Clinical Pathophysiology, Guitar Class, and Concert Attendance. 13 credit hours all together. I'll be on campus on Monday and Thursday, plus some random Friday & Saturday. The guitar class is TBA, so I hope it is in the morning, and won't conflict with work! I get to buy a new guitar. Very exciting. No more tuba, though, which makes me sad.
Work has been nice. I got to hang blood for the first time. I also got some good experience suctioning trach's. Good times.
I'm trying to get a piano moved from Albion to Fort Wayne on Saturday. I'm mustering recruits. It should be thrilling.

9/18 introductions, meetings, and dedications

Okay, I am going to try to blog again. I tried Xanga for a while, but I just don't like it very much. Sorry, but it's true. Inspired by Matt's Med School blog, I'm going to give ol' Blogspot a chance.

I'll try to talk about my life as a male nurse and make that the focus of this blog. I'll probably avoid talking about specific, significant others in my life. I may also rant about politics, philosophy, music, or religion. I will probably sound pretentious and ignorant at some point. That's okay because everyone is ignorant at some point or another and we all have a duty to present our views to foster dialectic discussions. If I am obstinate or obtuse, then it' becomes a problem.


Work: I worked from 3 PM until 3 AM last night. Not bad- that's my usual. I didn't get downstaffed, so I can't complain. I did get floated from 3P-7P. I went to ortho. It was my first time floating, so it was somewhat horrifying, however, everyone was exceedingly gracious and my patients were mostly medical anyways. I'd better get used to it, because neuro (my unit) is combining with ortho and trauma in November. The old-timey, cap-wearers are pretty ticked about it, but I've only been on Neuro for 6 months, so I'm barely a 'neuro nurse' anyway. I'm keeping my job, so really I'm sort of excited about getting some trauma experience. We had a joint staff meeting with ortho at 8 AM today to talk about this wonderful merger. That meant I only got like 3 hours of sleep last night. I can't complain though, I spoke with a family practice resident who said she worked over 100 hours last week! I always thought she was a bit short with us, I guess I can't blame her.

School: I'm officially sliding into the middle semester slump. I'm taking my classes for granted and just doing what I have to do. I'm putting forth an effort starting now to regain lost ground. It's hard to feel motivated about Stats, Professional Seminar, and Informatics. I love Health Assessment even though it's just basically rehashing basic techniques, at least it is clinically focused. My music class rules. I get to play my guitar. What else needs said. Music Minor: prognosis is guarded. Changes to my work schedule may make my dreams of a minor nearly impossible. We'll see!

Life: Good! Teaching sunday school with Ang. It's tough to get up early, but I'm really enjoying it. If I'm too crusty to work with kids at this age, then I've really got issues. I'm going to the CN football game on Friday. Good times for sure! I still need to make it out to a CN soccer game. I'm sure I will, it's just a matter of scheduling.

Music: Practicing the tuba daily. My tone is gross, but not as bad as it was. My sightreading is improving. Still focusing on longtones, buzzing, and scales. No banjo/mando practice as of late. I've been playing my guitar for class, so that is very cool. I actually HAVE to compose melodies. It's the best class ever.

Politics: Who to support for president? Nobody! I think I'll write in Jesus for president this year. Plus, what to do about healthcare? How can we maintain competition while making care affordable? It's a toughie. I guess people should just do what they have to do to get themselves insured, but I guess that's pretty naive. Also, gay marriage... should it be illegal? Should the government even be involved in something that is so religiously/philosophically based (marriage)? I'm not sure yet!

I hope I can blog as dedicatedly and as well as my sister, who's Xanga posts I look forward to in my inbox.