Crow for lunch?

Alright. I realize it has been eons since I last gave an update, but what can I say the summer and beginning of an accelerated nursing program appear to have gotten the best of me. But here we are now, New Coast, new school, new clinical placement, new life.

I think one of the hardest things about being a student nurse is that sometimes, no matter what you do, someone will come by and complain that you are doing it wrong. It never fails. Nurses are creatures of habit and let's face it, most of us are control freaks. It is how we are able to keep track of 6 patients at once, and let's be honest; how we keep our patients alive. So, though I am the last person to ever want to admit that I am wrong, I think the most important thing you can learn as a student nurse is to take it in stride, don't try to defend yourself or point to the page in the book that shows you did everything in the right order, just nod and say I'm sorry. (unless of course they ask you to do something dangerous, then by all means stand up for your patient). It never really becomes easy to do and, for me at least, bashes a huge dent in my ego. Bring on the feelings of inadequacy. Now that is the story of your first year!

It is crazy, you can read the books, take the exams, score 100%s and get straight A's, but the minute you walk onto the floor it all becomes too real. The cases you read about are real and the idea that a small mix up could have monumental consequences makes the pressure build, and before you know it you are second guessing everything you knew only yesterday.

I had a patient today s/p stent placement in the renal artery, with a h/o MI, HTN, chronic pancreatitis, dysrhythmias, you name it, this guy had a lot going on. I checked his vitals in the morning before giving 10am meds (including amlodipine and metoprolol for the HTN), and got a reading 150/90, a little elevated from last night and certainly not what you want to see in a patient on two different antihypertensives, but still not alarming. So I left the room to get supplies for am care, did my morning evaluation, and left to finish up my shift assessment before coming back to do the noon vitals. And wouldn't you know, about 10 min after I left the room (and by the way he was on contact precautions, so leaving and entering takes some time) ... the alarm on his IV infusion line starts going off .... "air in the line." awesome. I am on contact precautions in a private room with a patient getting heparin therapy (and by the way .. this is my 3rd week on med/surg ... awesome.). So my preceptor comes rushing in and asks me what to do next. Well, "remove the air from the line." "how?" "flush the line?" now .. pause .. here, right here is what I mean by the floor turns you into an insta-idiot. On the the exam you know never to push the heparin in too fast but on the floor you think, why not? the only way to get the air out is by running the line down to catch the bubble... dumb. So, preceptor saves the day yet again and my patient lives to see noon vitals. success! well, that is until noon vitals which showed a BP that had now risen to 170/80 and stayed pretty near hypertensive crisis until I left for the day ... looks like the NP is going to have to adjust the dose on those anti-hypertensives...

Everyday is a learning experience and sometimes, on this rotation especially, it feels like you can never leave the hospital with that wow I did good today feeling, but honestly, I don't know if I would want it any other way. It is hard on purpose. If you make a mistake in any other job it is a word or a number, but here is it someone's life.

But there is just so much to learn. About nursing, about work, about communication, and about yourself. I just hope that one of these days that confidence part will come into play.

I would like some catch up with a side of rant

alright ... now I know that when you are an NP you are a nurse first an an NP 2nd., but you have to admit that the job description of an NP is way different than that of a nurse, in fact you might even argue that the job desciption bears a greater resemblance to a physician than to an RN (except educated under a kickass school of thought, and lets face it more cost effective). 

So... if I have to endure one more conversation that goes something like... "why do you have to go all the way to the east coast for nursing school, you can do that anywhere on the west in only 18 months." I think I might just go insane. It seems like as far as the general public is concerned there is no difference, which is a problem unto itself. Though recently NPs have been gaining more ground, and lets face it, getting a bit more of the respect they deserve, I have to wonder why most of the general public is ignorant about the profesion, (especially when people are always complaining about the cost of healthcare and we offer a cheaper option) why you only hear "ask your physician" and never "ask your NP or clinician" in pharmaceutical commercials (which ... well, I suppose that is another rant for another day), and why people are constantly trying to push physicians to enter primary care instead of supporting NPs who went into the profession to do just that. 

Maybe I am just too big a conspiracy fan, but something has to be going on here. Maybe it is the physicians who feel threatened by people who can offer the same service at a better price, or maybe it is just a lack of NP activists, but somehow we need to find the source of the problem and stand up for the profession which .. fewf... i will now join! 

Don't get me wrong, I am excited to a nurse as well, because nursing is at the core of being an NP... I just think we NPs deserve a bit more publicity and respect :D 

Ready or Not.

The decision has been made and my future decided! Today I confirmed my acceptance to graduate school, ordered my Littmann (in raspberry ... just in case you were wondering), and decided that the sure thing was far superior to the unknown. It was definitely a difficult decision, but when I sat down with the pro-con list I realized that the only thing that made me hesitant to accept the offer was the academic calender which is completely trivial in the scheme of things.

So now, here goes ... the reason I started this blog in the first place.
If I have any advice for future NP applicants, they are as follows...
1. For the essay... just start writing. Write out everything you want to say in the first draft, pay no attention to length or grammar, just clear the pipes and let it out! In the end you will find that each school has a completely different essay requirement and having all of your ideas out on paper will allow you to pick which points to make for each topic.
2. Letters of rec: all I can say is BE ORGANIZED! Sometimes I think the nursing schools conspire to make it difficult, the due dates, mailing policies, and number of letters required for each school will vary, which makes it increadibly difficult for your LOR writers! So make a cover sheet with a checklist/instruction sheet for each school and give all the LOR forms to the person at once!
3. Clinical experience: if you don't have it, get it! I can't top my advisor on this one, so I will dispense her advice here, "How do you know that you want to work in healthcare if you have never worked in a hospital?"
4. Interview: before you jet off to the interview think of five things that you want them to know about you. It is just like making a meeting agenda, know what you want to talk about it, and adjust your answers to their questions so you talk about all five. Also, type up a list of questions for your interviewer... it will not only remind you of everything you wanted to ask, but make you look organized and like you have taken the interview seriously.

well.... that is enough advise for now. I am off to order my university scrubs and teal bandage scissors, and submit my request for housing. East Coast here I come!

My mind is a mess ...

I think this year has been one of the most emotionally challenging of my life. The constant cycle of not knowing, followed by rejection and tears is a bit more than I can bear at times. I think the worst part is being rejected and not being allowed to ask "why?" The only commonality I have seen between my rejection letters is "we think you would benefit from more life experience." a.k.a. I am too young! grr... since when did knowing what you want to do right away become such a bad thing? I know that I am only 21, but I also know that this is the right career for me. I know which school is best for me, but why can't I make the admissions committee see that? I just need answers and to know where I went wrong.

After my interview on the East coast about one month ago my interviewer said that "I would like to congratulate you on an excellent interview. You have a very clear understanding of what it means to be an NP, the demands of the profession, and the challenges facing the nursing field in the coming years. You have definitely placed yourself in a competitive position for admission to the program." Yet, after all that, I was still wait-listed, which is almost worse than being flat out rejected! grr.. it is like having a tied game ... you can't be excited that you won, or know that you lost so you can deal with it and move on ... there is no relief, just more anxiety!

I was accepted to another school on the East coast a week ago and though the program is good, and the school still makes the top 10 for graduate school in my specialty, the program is larger, and the location not as ideal as my top choice school, so now I have to decide. Accept this schools offer by mid-march, before I would find out if I was accepted by my top choice, or give up my acceptance in the hope that I am admitted from the wait-list. It really is a difficult choice, there is so much that will have to change if I go to the graduate school I was accepted to just because of the academic calender. I would literally have to start school under a week after I graduate from undergrad! Not to mention that I help run a group on campus called global medical brigades, and each year I take a group of students with me to Honduras to set up portable clinics and provide care to those in need ... and if I take this offer, there is no Honduras this year, and I have left 40 students in the lurch. I know that at the end of the day I need to do what is best for me and my career, but is this really best? Is it true that it does not matter how you got there... just that you got there? or does the fact that one university is nationally ranked a few spots ahead of the other really matter? And how much should your emotional attachment to the school play a role in this decision?

When I walked onto my top choice campus I just got this feeling that, this is it, this is home. I felt immediately comfortable on the campus and with the host student I was staying with. Everything just felt right and I could see myself living and studying there. But, how much does environment really matter? My mind is just a huge mess of questions and conflicting thoughts, and I am being asked to make this decision far to quickly, and I don't want to give up everything I had planned, and let down all of the people that are counting on me. yikes... why does this have to be so difficult?!?

I guess in the meantime I will just start making my pro-con lists and start writing an update letter to my waitlisted school. Damn this sucks ...

when the going gets tough, buy post-it's

Interview season is upon us and to keep with the spirit of the season I shall be jetting off to the East Coast where it is oh so much colder than it is over here on the west. And I mean SO much colder ... as in a 60-some-odd degree difference; I sure hope my wimpy west coast ass can take the cold.

A little over a week from today I have an interview at a rather prestigious graduate school on the East coast, and though I have spent the last few days overjoyed that I made it to the interview stage, it was not until the today that the fear kicked in ... crap... this is it! My entire future can be reduced to what I say to one person on one day in my life .. scheiza! But, when the times get tough the tough get ... organized? well... at least in my world they do.

So my sometimes, okay always, obsessive compulsive self sat down at the computer, copiously taking notes about said prestigious university, the international opportunities, class schedules, you know the usual (btw I wound up with a 17 page document.. too much?). But then I segued into a student network where the true horror kicked in .... yikes! While visiting www.sdn.net's interview forum I saw them .. reports from former student who interviewed at the school along with some of the questions they were asked in interview... yikes, i was even less prepared than I thought.. so, what is the solution? Why make a list of all the potential interview questions as well as a five page document listing each major topic I want to discuss in my interview with a short and a long response for each category .... and yes, in case you were wondering, i do realize i have problems, but if post-it's and 3 ring binders make me feel all warm and cozy in an otherwise terrifying situation, then by golly I will use three hole punches, dividers, and sticky notes to my hearts content!

About Me

Yes, the most unoriginal title in the history of title-ing, but I promise... originality will improve with time. 

So, here is the scoop ... I am currently a senior at a small private university on the west coast majoring in biochemistry with an emphasis in exercise physiology (overachievers unite!) and trying to make the rough transition to graduate school. I decided that I wanted to be a physician at the age of 14 because that is definitely the age when you should be deciding your entire future ... yes, I was quite old and wise.  I kept the dream alive until I met a remarkable PNP who made me reevaluate my entire future, and in the summer before my senior year I decided that I had to be an FNP. 

The programs I am applying to are accelerated programs designed for people with non-nursing bachelors degrees. The competition is stiff and at times the wait to figure out where I will end up next year makes me want to crap my pants, but in the midst the feelings of fear and stress, I could not be more excited about the future. 

So here is where I am today... waiting for others to decide my future. I sure hope they like me.