pause for effect

Apparently, I had to go put a few quarters in my attention span.

I did indeed get a 105% on my first statistics exam. The second one is tomorrow; I'm not expecting any trouble.

I'll be in-house at the transport job tomorrow. I have yet to show my face down there on the clock during business hours, so it's probably a smart move. I'll be bringing some stuff to work on for the professionalism project, and will be attempting to track down the doc who'll be involved, as well. I've been neglecting that project for a few weeks. A couple of ideas have been incubating, but I need to expose them to light and oxygen and see how they do.

I'm also contemplating my next move professionally. I'd like to get some more ICU experience; I'd also like to have a little more cash on hand. There's probably a synergy to be exploited there, somewhere. I've been putting this off, not being in a hurry to be the rookie once again. I keep finding, however, that the interval between, "I'm comfortable" and "I'm bored" is a fleeting thing indeed. Time to go learn some new stuff.

too much to ask?

If I get anything under 105% on that statistics exam tonight, I'm going to be bent out of shape.

Because I can just never help myself, I corrected two spelling errors on the exam before I handed it in.

hubris?

No school for me last night; no point. The exam is tomorrow; I'll go show my face tonight, and make sure I'm not missing anything. It's so damn simple, though. I wish I could have figured out how to do the preparation myself.

I'm amazed what a difference it has made academically to go back to the truck full time. I made next to no academic progress for nearly a year after getting my license. Granted, I was busy learning how to be a nurse.

A friend of mine, who has been a nurse for about a year, was complaining to me yesterday about feeling abused at work. She'd worked triage, and several times, she'd had to argue for her judgment calls with the nurses in the back. I felt badly for her. Nobody from the medical or nursing staff has really given me a hard time in quite a while. I'd like to think that it's because I've gained their confidence as a clinician, but I think it's more accurate to say that they've decided that it's not worth it to get me torqued up. I wish I could say the same for the ancillary staff; a few of them are wonderful, and a great many of them work harder at avoiding work than at performing it. And their pain threshold is much higher than that of the nursing staff. All it takes to get the average nurse or physician to stop bullying is direct eye contact and an assertive remark. The techs are far more difficult to manage.

nerdware

I just got back from an overnight trip to Vermont for a wedding. I didn't really stay long enough to decompress, partly because I'm not quite ready to, and partly because I think I'd have an easier time of it elsewhere. I'm at the point where I need substantial distraction to get myself to the point of relaxation, and I didn't think I'd quite find it up there. It was a good excuse to catch up with my family, especially my brother. We sat around and compared notes about events both current and twenty years old. I hope that conversations like the ones we had over the weekend increase in frequency as we grow older.

I have my first statistics exam this week. I bought a scientific calculator that should get me where I need to go, and which only set me back about eighteen dollars. Provided everything makes sense in class tonight, I'm blowing off school tomorrow to do on-call for McCabe (unless they decide to schedule the exam for tomorrow, of course).

like clockwork

Last night, I recall, I was reflecting on how not fancy life was feeling. So OF COURSE at school tonight, I strike up a conversation with a classmate who is 26 years old, has FIVE kids at home (ages 5 through 9), and is chipping away at community college because she desperately wants to get into nursing school so that she can give them a better life.

My attitude about going to this statistics class still sucks, of course, but at least now I have the common decency to be ashamed about it.

class / consciousness

I had a moment of truth at about 7:30 tonight. I had just punched out at the end of my shift, and I was hitting rush hour on Route 4, still in uniform. I reflected on the fact that I was a thirty year old shift worker driving a seven year old car, eating a fast food cheeseburger on my way to night school at the local community college. Not very fancy. In fact, I felt like some sort of poster child for the 21st century proletariat, or maybe the subject of a Bruce Springsteen song.

That, of course, smells of bullshit. I've got everything I need, and a lot of what I want. I've been given a lot of resources, and consequently, I have high expectations for my ability to contribute. I'm not an elitist, but I know I'm pretty smart, and I'm used to fairly consistent success. It's probably not such a bad thing, then, that I was reminded tonight that I'm still no better than anybody else, and am as likely as anyone else to get ketchup on my shirt if I try to eat my dinner on Route 4.

I have eight more weeks of this consciousness-raising to look forward to. The statistics class itself looks like a cakewalk, and they're not counting attendance. We'll see how I do after a shift in the ER tomorrow.

Enacting Connectedness in Nursing Education (article)

McGregor, Alix. Enacting Connectedness in Nursing Education. Nursing Education Perspectives, Mar/Apr 2005, Vol. 26, Issue 2, p 90-05

This article discusses how failure or its threat contributes to a high level of stress in nursing students, and how much of this stress is the result of inappropriate, and even abusive behavior by nursing faculty. The article draws a link between the maltreatment of nursing students by faculty, and the high rate of attrition from nursing programs. (p 91).

It's very good to see some academic discussion of nursing's longstanding tradition of eating its young. The pervasiveness of this practice is part of what encouraged me to pursue my degree through distance education -- although, as I mentioned in my last post today, some of the clinical educators I encountered while completing my performance exam seemed intent on making up for as much lost time as possible.

I'll cite this article in my reflective paper, as it helps to inform a concern I have about how to perform the training. Mike mentioned that in the past, some of the nurses have resisted learning the skill, stating, "we're nurses, we don't intubate". While that's usually true, it's not the case in the transport setting. However, it's a low-frequency, high-risk skill, and the nurses are justified in having some misgivings about being responsible for it.

I'd like this training to result in the nurses being better prepared and more confident when they go out on a transport. My concern is that the nurses will instead be intimidated, and part company with the service. Worse yet, I'm concerned that the medical director will wink at the whole thing and just sign the nurses off before they become competent, playing the odds that they will never have to perform the skill. While I would hope to never be abusive, the critical nature of the skill and the potential resistance of the staff mean that I am going to have to walk a fine line to be both supportive and effective.

timeline

I logged ino Excelsior's website on Friday and found that they are offering an online equivalent to the Health Assessment and Promotion exam. This is fantastic news; I was really dreading the thought of driving back to Albany and squaring off with those nurses. I lost a lot of stomach lining to my last Excelsior clinical performance exam.

The only problem with the online class is that there is no flexibility in terms of scheduling. It starts in September, and lasts sixteen weeks. It would be far less attractice if I were more confident that I could nail the performance exam on the first try, and not drive myself completely crazy preparing for it.

That leaves statistics, the research exam, and the professionalism project, all of which should be complete by the end of the summer, and the teaching assignment. I started to prepare for the teaching project last spring, but I got aggravated by the requirements and let it drop. I'll probably have more confidence to tackle it after I have the professionalism project under my belt.

The final requirement is the baccalaureate capstone course, another online class. That class is offered in January, May and September, and is only open to students who have completed all other nursing requirements for the degree. It would have been great to have everything done in time to take that course in September -- that would have wrapped up the degree right before my lease ended, leaving me free to bounce. Unfortunately, adding two performance exams to the summer's courseload would be sort of crazy.

I'll call Excelsior in the morning and see if it would be impossible for me to take the capstone course at the same time as the HAPE. Maybe I can pull the teaching assignment off before September.