Ungarnished Reality

All wired up

Anyone who's ever had the immense pleasure of sharing a bed/hotel room/cabin/tent with me knows that I now and then occasionally frequently often almost always snore fiercely enough to rock the heavens. My snoring can get so loud sometimes that it actually wakes ME up. Seriously, I'm surprised we don't have stress fractures in our bedroom windows. If it weren't for the advent of ear plugs, I'd probably be single. I've always just chalked it up to the extra 10-20 lbs I've been carrying around these past few years. I have one of those weird bodies that accumulates excess body fat in limited areas (in my case, my abdomen, face and neck) while the rest of me remains lean and mean. I figured that the fat was constricting my airway while lying supine.

 

Standard precautions

Were you ever so mesmerized by something someone was doing in front of you that you catch yourself staring at them in an odd mixture of incredulity, fascination, and revulsion? You know, like pulling up along some guy at a red light and notice him digging for treasure with his index finger thinking, "Nah, he can't be doin' what I think he's doin'?" That was me this morning, while I was having my blood drawn at the doctor's office. The woman (RN/LPN/MA/receptionist/cleaning lady?????- she wasn't wearing any ID) proceeded with the phlebotomy without washing her hands and donning any protective barrier(viz. gloves).

After she withdrew three tubes, she placed a clean 2x2 gauze on the puncture site. After I applied pressure for about 30 seconds, she said that I could throw it in the container down by my left foot, but to be careful not to put my hand in it. I looked down, and there by my bare leg was the sharps container, 3/4 full with NO TOP! I threw my bloody gauze on top of the heap of exposed hazardous waste. My clinical instructors would have had a litter of kittens if they bore witness to what I had seen. I didn't know what to say, so I didn't say anything. I just know that somewhere down the line, there will be a needle stick injury, and it'll probably be a kid. Same with the urine sample: no instructions, so I did it the same way that I instruct my patients to do it. I returned to the room with my specimen and asked her where I should place the cup and she replied, "Oh, just give it to me," and took it with her bare hands. Perhaps I'm overreacting, but unless you're my partner, I don't touch anything that's wet, warm, or sticky that didn't come out of me. In addition to the obvious risks, I wear gloves when I carry lab specimens and when I change beds. I also clean my hands before and afterwards. I just thought it was so gross.

I hope I'm not becoming mysophobic!

A tale of three hospitals

In the past week, I have been in three hospitals: twice as a prospective employee, and once as a concerned family member.

My mom is in the hospital, and nobody knows for sure what's wrong with her. Seriously, she's had at least eight doctors come by and see her since Friday. She was having trouble breathing for the past two weeks (she has COPD), not that it stopped her from going to Foxwoods last week to celebrate her birthday, mind you. She said that as long as she stayed at the same machine, "she was fine" and only experienced dizziness and dyspnea while walking around. Keep in mind, this is the same woman who didn't leave bingo when she was experiencing TIA's a few months back. She used to complain that she hated how Nana (her late mother) would never call and ask for help for a health-related issue until the situation was such that it warranted a trip to the emergency room. My mother is slowly turning into Nana.

Dream come true

I 'm a nurse!!!!!!

 

When my NCLEX-RN exam ended last Tuesday, I was not confident that I had passed. I didn't feel as though I had failed, but I didn't walk out of the test center filled with eager anticipation to see the test results, either. Actually, I've suffered from nausea and insomnia these past two days just being worried sick over it. Most of that is due to the nature of the exam. The NCLEX exam utilizes Computerized Adaptive Technology, which basically means that the questions you're given are based on how well you answer the preceding question. Get a question right, and the next question is a little harder. Get that one right and the next one is more difficult still. Get one wrong, and the questions get a little easier. My test shut off at 75 questions (the minimum), which meant that I answered enough difficult questions that the Board didn't feel it necessary to continue with the exam; or that I answered so many incorrectly, that the Board didn't feel it worth the time to continue with the exam.

Seriously, both prospects have received equal billing in my mind for the past 48 hours.

But that's over now!!

What was only a dream a few years ago is now a hard-won reality. It was a long road, involving lots of discipline, sacrifice, and hard work. It was all worth it, and I wouldn't change a thing. Going through the process felt like traversing a narrow, dark tunnel. I had to keep my eyes forward and alert at all times, lest I would have tripped and injured myself. If I let my fear take hold of me, I would have felt the tunnel walls closing in on me in a fit of claustrophobia. Now, I stand outside the opening with my face toward the sun (protected by 30 spf sunblock, of course).

Sometimes it felt like one of those dreams in which you're running down a corridor, and the corridor continually stretches out in front of you (like an optical illusion) so it feels like you're stuck running in place, no matter how much effort you exert.

I couldn't have done it without the love and support of my partner, Jeff. I hope he knows that when the time comes to follow his true calling, I will have his back.

Thank you to all of my friends for being so patient with me as I basically disappeared off the face of the Earth for a year and a half.

Oh my God, I get to go on vacations again! and read books for pleasure! and blog! and make money! and...

Ahhhhhh!!!!!!!!!!!!!

 

This is how I feel today. I'm sure I won't sleep a wink tonight. I don't feel ready for the exam, but ready or not, here it comes. Hopefully, in a few days, I'll have a couple of more letters after my name!!

100 hours

Somebody just got a little bit older and wiser in the house yesterday!

 

Shout out to Ohlin's Bakery in Belmont, MA, where we've been getting our birthday cakes since 2002.

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According to local experts, graduates sitting for the NCLEX-RN exam will significantly improve their chances of passing on the first try if they adopt a 100 hour study program. Similar to a beginner's running program, in which one learns to decrease the amount of time walking and resting and increasing the amount of time running, the study program is geared to wean the exam candidate from reviewing content in study guides and books, to successfully completing practice exams. The goal is to be giving the practice exams a black eye in the days preceding the actual test.

  

Anyone who's ever been in a nursing program will tell you, NCLEX-style exams are a unique species on this planet. There's nothing like them. In my "past life' as an accountant, and as a pre-nursing student, I took knowledge-based tests. There was always one correct answer. You know, 2+2=4, that sort of thing. In nursing, the exam tests your knowledge, but also your critical thinking skills. The answers themselves may all be valid and appropriate for the patient's condition, but the question may ask you, "Which would the nurse do first?" Trust me, it's way more difficult than it sounds.

So, since I don't have a job lined up yet (I'm in the same boat as 2/3 of the graduating class), I decided to pick a date to take the exam that would put enough pressure on me to motivate me to study, but would allow me enough time to take the test in confidence. I also added in buffer time so that I won't be caged in the house the entire time. I registered for the exam as soon as I received my Authorization to Test, and boy, am I glad I did. Appointments in the Boston/Worcester area are disappearing fast! I secured one about a week later than I would have liked, but if I had waited, it probably would have pushed me into mid-July or later, or forced me to take the test in Connecticut.

I'll let you know when/if I pass the exam, but only after the fact. I don't want anyone to know the exact date because I'm afraid it'll make me too nervous!

Ethical dilemma

As many of you know, I'm sort of in limbo as far as nursing is concerned. The Commonwealth of Massachusetts does not recognize the status "graduate nurse", therefore I can't practice nursing until I pass NCLEX-RN and receive my license from the Board of Nursing. Other states allow persons who have graduated from a school of nursing to work as nurses in that 'twixt and 'tween stage between getting the degree and passing the boards. Add to the mix the fact that the job market for new grad nurses absolutely sucks in the Boston area, and you're looking at a few months (at least) before I can work in earnest as an RN. Yes, there is still a nursing shortage for experienced nurses, but there's slim pickin's for newbies. There are so many nursing schools in the metropolitan area that supply has exceeded demand. That's not the case elsewhere in the country. In the southwest (like Phoenix, one of my favorite cities), I could probably get a job in several hospitals, at a competitive salary, even as a new graduate. 

So, knowing that I will most likely become an RN months before working as one, I asked my supervisor what the hospital's policy was of me continuing to work as a PCT (patient care technician- an unlicensed position) once I get my license. Her response:

She said that if I come forward and let them know that I am an RN, I can longer work as a PCT, but if I keep my mouth shut...

Thus, an ethical dilemma. One of the principals of ethical nursing behavior is veracity, which includes not intentionally deceiving or lying (particularly to patients) in the course of nursing practice. That's on top of the potential legal ramifications. For example, RN's are obligated to report abuse to minors, the handicapped, and the elderly, even if it's only suspected. What am I obligated to do if I'm working as a PCT with a nursing license? There are hundreds of scenerios where my failure to act could set me up for a lawsuit.

Lawyer: "You should have known better as a nurse".

Me" "But I wasn't the patient's nurse, only the PCT".

Are nurses nurses 24/7? Or do you get to hang up the cap at end of the shift?

Why don't I quit my PCT job? Well, I sure as hell don't work there for the money. My hospital, like most hospitals, have a policy of hiring preferentially from within. So, by virtue of being on the payroll, I would (theoretically, at least) be toward the front of the line when/if an entry-level RN position opens up. BSN programs tend to graduate in May and December, so by the end of the summer, the mad rush of fresh graduates should abate, and the odds of getting a job in a reputable hospital will increase.

Thank God for my other degree. Though it would kill me somewhat inside to don business casual clothes again (yuck!), realistically, I can't hang around the house all summer doing nothing. I can make some good scratch as a temp accountant. Plus, as a temp, you get to leave work when the whistle blows! You can't do that as a full-time professional.

No! Nein! Nyet!

 

 

I was psyched to read the results on the Metrowest Daily News website:

 

ASHLAND —

Voters yesterday rejected a Proposition 2 1/2 tax override for the schools by a thin 49-vote margin, leaving supporters hanging their heads after crowding outside the town clerk's office to hear results.

The $496,000 request failed 2,171 to 2,122, with 42.7 percent of the town's 10,118 registered voters showing up at the polls.

This is why I try to never miss a chance to vote. One of those 49 votes was mine. If the override were for services such as fire, police, etc., I'm all on board with that. But don't mismanage the school system and expect childless couples to foot the bill. I did the math. If all the "yes" voters wrote out checks to the school system today for $234, the budget deficit would be bridged. And if you whine and bitch and complain that you don't have $234, you also better not have cable television, internet access, designer clothes, or a newer model car. If $234 means the difference between you eating or paying your heat bill, come see me, and I'll give you the cash myself. Otherwise, move to another town. It's not my fault the existing town administrators favor building crappity-ass condo complexes all over town rather than try to lure successful and lucrative business ventures. I voted for their opponents.

And less than half the regisisterd voters bothering to show up? Pathetic!

Of course, part of this is due to a little selfishness. We're looking to build a new home in Ashland, and we're worried about the increase in property taxes. More on that much later...

Pinned and proud

Last Saturday the clouds cleared and the sun shone on what was one of the happiest occasions of my adult life. I received my nursing pin! What's the big deal about the pinning ceremony and why aren't I making a fuss over the actual graduation ceremony? Good question! Glad you asked.

The pinning ceremony is an intimate ceremony at which friends, family, and faculty of the new graduate nurses gather to symbolically welcome them into the profession. No degree is conferred (that takes place at commencement), rather you are presented with your nursing pin, which is unique to each school. Each school chooses how to conduct the ceremony, and they can range from all-out traditional with students wearing the white uniform (à la "Dixie McCall"), reciting the Nightingale Pledge, and the lighting of the lamps (which symbolize vigilance) to a more modern ceremony (for which we opted), where we dressed semi-formally (think wedding attire) and we passed on the Nightingale Pledge (a little too subservient, if you ask me). The only symbolism was the red rose we were handed along with our pin. The bud and the thorns represented the two sides of our profession- the beauty and the pain, and the fact that they exist simultaneously. Walking across that stage and accepting my pin from a nursing professor was one of the proudest moments of my life (and I've done a lot of cool stuff in my 41 years!).

I didn't go to commencement yesterday (where I was awarded a BS in Nursing) because it wouldn't have been particularly special to me, and probably would have bored me and my family to death. Whereas the pinning ceremony was just over an hour long, and was open to anyone, I was limited to the number of invitees for commencement, and I think the ceremony was over twice as long (there were 700+ degrees being awarded). It wasn't that it was just "been there, done that" when it came to graduating (I already have a BS in another field), it was more due to the nature of my nursing program.

The nursing program I was in (accelerated second degree) was full-time and cohort based, meaning I was with the same 29 people (there were 30 of us) for every class for the whole 16 months. We were broken up into smaller groups for our clinical placements, but essentially, when all is said and done, I only know 29 other students in the whole college. This differs from the traditional nursing students who (primarily) live on campus, are involved in student activities, eat in the cafeteria, go to parties, go on spring break, etc. Graduating means saying goodbye to possibly hundreds of friends and a lifestyle they've had for four years.

So most of us "non-traditional" (PC for "older") students chose to partake only in the pinning ceremony. There were only about 100 of us being pinned, and the venue was full of only our friends and relatives and faculty, so it was "all about us". The hardest part was knowing that I would not see some of my classmates ever again. I'm lucky that I came out of it with some friends (one who happens to live in the same town not too far from my house), but the majority of us will go our separate ways. Such is the nature of the beast. Being older, most of us own homes, are in relationships, some have kids, some live far away...basically, we had lives prior to starting nursing school, and we're looking forward to slipping back into them as we make the foray into our new profession.

Thanks to all of you who cheered me on during this arduous, but unbelievably rewarding journey!

Last day of school!!!

And I aced my finals!!!!!

It's official, friends...I'm getting pinned on Saturday!!!!!!!!!!