Not Nurse Ratched

I’ve been standing behind myself with a cattle prod to force myself to study for my final final, which is in Leadership. I know there are good theoretical reasons that we have to take the class, but it seems so out there and so irrelevant. Am I really going to have to know the six steps of budget reconciliation, in the specific order of one textbook, when I am practicing? If it focused on major themes and practical application, I would see the point of it more. However, it is pointless rote memorization. It’s silly, but I do WAY better on complicated math and science than on this nebulous stuff.

Whatever. I think even if I totally blow this final, I still will get a B in the class. That doesn’t thrill me to pieces, but considering that I have barely gotten through the semester at all without dropping out of school, a B wouldn’t be the end of the world.

I got an A in Research by ONE point…color me shocked! I am soooooooo glad to be done with that class. No class has ever encouraged gun to scalp more than that one. I got a super high A in clinicals and will probably get an A in my med-surg lecture class. My CI was very complimentary in our grade conference. I liked her a lot and hope my capstone experience goes as well as this semester did. I learned a gazillion times more this semester in clinicals than in past semesters!

That’s about all she wrote right now. I’m going to take my Shuffle and go for a prefinals butt-kicking run and then stare at my PowerPoints one last time before lift-off. I hope everyone is finishing up and feeling fab!

The readership should take it as an obvious point that because I should be vigorously readying myself for the end-of-semester hoo-hah looming ahead of me, I am instead poking around and immersing myself in technological geekery. I am all studied out. I am also still ceaselessly exhausted but have stopped sleeping all the time because I never feel rested. I feel certain I have mono but see no point in getting a Monospot; even if it is positive there is no treatment. I’m not licking anybody to spread it around!

I have turned my attention to my neglected Centro. I know a few people with recently purchased Blackberries, and I experienced Blackberry envy, but on closer investigation the envy stemmed from novelty and no other good reason. People are howling that the Palm OS is dead, but it actually works pretty darn well. I’ve had a Palm since the very first models, and perhaps the OS hasn’t changed drastically because it worked fabulously to begin with. The browser does indeed suck, but the Blackberry browser sucks even worse. My Mac iCal and tasks sync flawlessly to the Centro (with the help of Missing Sync). I have Sprint, and the EVDO network is satisfyingly fast; I mainly use the Web for sites that have mobile-optimized sites, so I don’t suffer much. The Centro threads SMS messages in a helpful and usable way. It cooperates seamlessly with my Mac Contact lists.

Granted, I have added a few programs to the Centro that make it WAY better than an out-of-the-box unit, and I don’t know how the plain old Blackberry stacks up. I have Agendus and Agendus Mail (both Iambic products). I have owned Agendus for years so I didn’t have to buy anything extra with the Centro. (I just don’t feel the need for the latest and greatest with this program.) Agendus Mail is $20 or so, and I similarly owned it previously. You can get Snappermail for $60 that will do SSL and IMAP, or you can pay a third of that for Agendus Mail, which does SSL and IMAP; hmmmm.

E-mail is one of the possible deal-breakers between Blackberries and other smartphones. Sprint’s Mobile E-mail app tantalizes you with the option to “push mail to device.” Trouble is, sometimes it works, and sometimes it doesn’t, regardless of which ISP you use. That app and Versamail are not plagued with fatal doses of stability, either. They hang and crash occasionally. Always have. Agendus Mail doesn’t claim to push mail to the device, but you can set it to poll for e-mail, and it actually does it. In actuality, it therefore ends up working better than the “push” from Sprint’s and Palm’s apps. If I were truly foaming at the mouth to know exactly when each e-mail arrived, I could arrange to have a text notifier sent each time I got an e-mail, but even I get tired of text message beeps every 10 minutes.

Finally, I added a $6 app called MissedCall. I would add a link, but it moves around. Go to Handango and search for it. It basically adds a feature that Palm left out through, one assumes, a result of a transient ischemic attack: a visual indicator that you have missed something. Even the cheapest crap phone will blink or something if you have a missed call or text, but not the Centro. It is supposed to, I think, because you can pick “flash LED” for some things, but the only time my LED ever lit up is when it was charging. Result: you have to constantly turn it on and look at the screen to see if you have missed a call. MissedCall lights the LED so you don’t have to do it.

So. I think the Centro gives the Blackberry a decent run for its money. It’s also cute. And cheap. And despite my decided pro-Apple bias, I would much rather have it than an iPhone. The iPhone looks sleek, but they’re hard to type on, you can’t add extra programs to them (I know, I know, this is about to change), they’re wicked expensive, the EDGE network isn’t blindingly fast, and…did I mention they are a huge pain in the ass to type on? I do wish the Centro had a regular headphone jack on it, but my Shuffle isn’t exactly a hideous load to add to my bag. The Centro may bail Palm’s butt out of the sling it’s in!

Like many folks, I bought a bunch of software from Skyscape and was pleased as punch at not having to carry around bulky books. I had to reset my device, which changed my device ID, and I e-mailed their customer support to get new codes. Well, since my subscriptions expired, I have to PAY again to get the software. This is crap. If I had bought a paper drug reference manual, I’d still be able to look at it even though I wouldn’t have the latest and greatest updates. Similarly, my Mosby’s Reference Manual still has a ton of useful stuff in it, yet Skyscape won’t let me have the OLD versions that I bought! Why is this not illegal?

I’m so done with them. Watch out if you’re considering using their medical software: you have to pay repeatedly for the same book even if you’d be perfectly happy with a slightly outdated version. It’s highway robbery. Go with Epocrates. Grrrr.

Ever since I got my tiny silver 2G iPod Shuffle that clips on so easily to my clothes, I feel that I have my own personal soundtrack. How did I manage to scrape by without this widget? They’re fairly cheap now too. I heart my giant Classic as well: don’t get me wrong! It’s just wicked cool to autofill this little Shuffle and have a day’s worth (plus) of my music on a gadget the size of a postage stamp. It dazzles the mind. My first mp3 player was much larger than the Shuffle and held about 1 CD’s worth of songs! I’m getting old. I also remember having to use 1200-baud modems to dial into terminal servers and type cryptic commands to use the Internet. Soon I’ll be talking about the days when I had to walk to school 10 miles uphill. Both ways.

I got suddenly sick on Saturday at work. Literally one minute I was fine and the next I had the most wicked sore throat ever. I felt tearful each time I had to swallow. I spent Sunday and most of yesterday in or near my bed, wondering where oh where my immune system has gone. I hope that my immune system catches up my new career, because I am sick a lot and never used to be (when I worked at home and never went around a really sick population, duh). I am not used to being sick and feel very pathetic when I am dragging around feeling miserable. Fortunately I got an EA (excused absence) Sunday because there were no patients on the unit anyway, so I didn’t feel bad about staying home.

The semester is drawing, mercifully, to a close. Most notably, tomorrow my dreaded Research class ENDS. Finito. It would be impossible for me to describe the sense of relief I anticipate having. Prisca from N is for Nurse…Finally wrote this post that caused me to feel a little better, oddly. I keep thinking I am just insane and uncharitable, thinking that these faculty are deliberately making this more difficult than they need to be: but no, they really ARE doing that.

I’m drinking coffee and trying to wake up before my 2 weekend shifts. I tried to finagle the situation to where I’m assigned to a NICE RN because I just don’t want to dread my weekend. Normally when I try to control situations they blow up in my face, so we’ll see. Be that as it may be, I’m feeling pretty positive about nursing right now. I took three patients this week in clinicals for the first time, and I figured I wouldn’t be able to handle it at all. Instead, I did just fine, all things considered. I am still slow with all the pieces-parts that nurses have to deal with (I don’t have finger-memory yet and fumble with alligator clips and IV tubing…), but I got much better even within the space of 2 days. With THREE patients, there is more opportunity for practicing with pieces-parts. Thank god for RNs who are patient and understanding with students. Mine this week was helpful and also forgiving. When I made mistakes, she said things like, “I can’t TELL you how many times I’ve done that myself” or something similar so that I didn’t feel like a complete moron.

I also learned a handy tip for anyone who, like me, feels like being really helpful and compassionate and saying to a patient undergoing a painful procedure, “Go ahead and squeeze my hand as hard as you need to.” (The tip is don’t do that.) My hand turned purple and my fingers are now black and blue! I was a champ and didn’t leap around going, “Ow! Ow! Ow!” But I spent the rest of the day clutching the hand and thinking unprintable epithets.

It’s too bad that so little of what I am learning in school this semester is in fact applicable to NURSING. I think I would thrive in an environment that focused on pathophysiology, pharmacology, diagnosis, lab values, and treatment rationales…crap, that sounds like med school. I’m so not going there. But seriously, I feel most on my game when my CI descends on me and drums up a series of trick-the-student questions (she’s famous for this: “why do you think the patient had this test? why do you think the patient is taking this drug? what really obscure side effects should you be alert for? what patient education will you provide regarding this diagnostic test? what lab values does this drug alert you to look for?”). I’m like a game show contestant. “Oooo! Ask me another one!”

But this weekend I am but a lowly nurse tech, wipin’ butt (but competently so, heh heh).

I have been prowling around Cathy Glasson’s Facebook page and watching videos like this one:

as well as material at the Healthcare United Web site. I’m nearly propping my eyelids open with toothpicks to view this material while I knock back a cup of coffee before heading off to the hospital, and I’m sure I’m not the only one. Where do these nurses get the time and energy? We all need to be doing this stuff. Nurses could be a formidable force if we banded together, but no one needs to look very far for the obstacles. I really doubt it’s a lack of caring. Nurses are just darn worn out.

I’m close to being an RN, BSN and need to be thinking about how to fulfill this part of my professional responsibility (advocating for change), but frankly it makes me feel overwhelmed. How can I do that when I am barely managing to drag both myself and my bad attitude to school every week? Yet I don’t want to be one of the grumblers who just complains and complains while letting others do the work for them. It’s something to think about. Meanwhile, I’m really grateful for the nurses who ARE out there working for change.

I could title this post “the same thing happens every week.” Every week, I get through classes and arrive poised on the brink of clinicals with the worse attitude you ever saw. I’m pissed off at everybody and everything and want to quit school (in a huff, if possible). Every week, I am instantly energized and excited about nursing the second I arrive at a patient’s bedside.

Do I recall this from week to week? No.

It must be brain damage caused by extreme tiredness…

I’m making an executive decision: today is NOT going to suck. It’s going to be a good day. I will be surprised and pleased at the power of a positive attitude. Thus has NNR decreed.

To start off, I would like to discuss the iWrap I got recently for my 80-GB iPod Classic. I got it more than a week ago, but I have been trying to decide whether I liked it or not. I’ve decided I do like it. It takes a while for the wrap to stick correctly to the iPod—thus my waffling. This stuff is like bullet-proof Saran Wrap that precisely fits your device. They send you magic spray stuff that you spray on your fingers, the wrap, and the iPod so that you can position it correctly and not have it stick to your fingers.

The application was an unmitigated pain in the butt. I was really careful, and I still ended up with the back panel a little off. I couldn’t scoot it up to where the corner pieces didn’t stick out a little. However, it turns out that this is no big deal. The sticky-outy parts have kind of melded down into the iPod after multiple days riding around in my pocket.

I bought the iWrap because my iPod looked so cool that I hated keeping it hidden in a case yet didn’t like tossing it in with stuff that might scratch it, which includes…pretty much everything. I like being able to just carry it around without a big bulky case. REALLY like it. The iWrap film has settled down and worked out a few tiny bubbles it had, so the screen is fab and glossy (with no scratches!).

Yeah…me and my iPod, we got a real good thing, and the iWrap is a good way to keep the iPod pristine. Unless I have one of my small strokes and hurl it on the floor, as I tend to do with mechanical pencils into which I have just installed new leads…

I had my in-class research critique this morning. It sucked. I knew it would suck. The only thing that will suck more is if I have to look at what she marks wrong on it (a fate I hope to avoid). The good thing is that it is now over, and assuming that I do not fail I will never have to do it again. Then I attended the worst lecture ever delivered. It contained 89 PowerPoint slides, which were delivered rapid-fire in 50 minutes. Every third word or so was mispronounced (”Ch…Ch…Chvostek” is my favorite; “steatorrhea” totally defeated her and was delivered as “er…fatty stools”). What is the most common form of chronic pancreatitis? Don’t ask this lecturer, because she had a few of them labeled as such. She’s also a big fan of 2-hour, not 24-hour, urine collections, because those are so useful. I’m really sick of these people wasting my time and sucking me dry. That lecture COST me time. I could read the slides and book at home without the commute and without the confusing and incorrect commentary that I now have to sort through.

If you don’t know what you’re talking about, get the hell off the podium. Giving me wrong information WASTES MY TIME. Just don’t lecture at all.

My really long day ended up with Leadership ATI testing, which I somehow passed with a level III despite feeling I knew none of the answers to the questions. So that actually didn’t end up sucking as badly as it could have.

Yeah…there was more suckiness involving two (non–nursing-school) friends acting like assholes. The final act was the intrepid NNR bursting into tears of tired frustration which evolved into sobs and then coughing and, finally, puking. I never got so tired that I ended up puking before nursing school.

This is INSANE. I am standing behind myself with a cattle prod to get through the next few weeks and finish this semester.

Prod. Prod.

My blog titles are always bimodal, it seems. First nursing, then geekery. I had adventures in professional communication during my shift on Sunday. I was paired with The RN No One Wants to Work With (for good reason). I don’t know if this will work even half the time, but I gathered my ‘nads and approached her directly, asking her to cease to yell at me in front of patients because it made us both look bad. This worked. She apologized and we worked really well together for the rest of the day. It amazed me completely. I’m getting a lot better at appropriate communication. I used to shake and feel vomitose about it, but I’ve gotten up to a point of feeling only mild queasiness when I have to do it.

Also, I found that coming on to a 12-hour shift when you’ve had a day off beforehand is a far different matter from hitting it when you’ve already had two clinical days in the hospital. Shocker there! My day was wicked busy and I ran my ass off, but it didn’t seem nearly as bad since I wasn’t exhausted to begin with. Major difference. I’m not burned out; I’m just tired. Good to know.

Readers know that I’m a productivity junkie…so much so that I waste a lot of time tinkering with technological ways to allow me to save time. We all have our peccadilloes. For the last few weeks I have gone back to plain old Mac-included software and one downloaded dashboard widget (DoBeDo). I really like Remember the Milk (but gave it up because it won’t sync with my Centro without lots of hoop-jumping) and still use Sandy for occasional reminders, but for the day-to-day stuff I have fired Gcal on grounds of attendance problems and insubordination and have started using plain old iCal and Apple Mail. My events and to-do’s sync perfectly with my Centro this way. Mail is actually pretty handy. I turned my nose up at it previously, but I am making good use of the notes and the incorporation of to-do’s and files.

For example, I keep a folder called “Project notes” and keep one note per project in there. Each note has to-do items for that project and other notes I have made about it. Very handy. I use smart folders for my to-do’s and also use DoBeDo in dashboard for a quick glance.

Apple has a few numskulled problems to fix with Mail…for example, in what universe does it make sense to not be able to logically create “New To Do” from an IMAP e-mail message? It adds them all to the calendar “calendar” and doesn’t give any other options. With POP accounts it works the way it intuitively should. This is a bug, because if one checks the box next to “create new to-do’s on my Mac,” it should freaking DO that. This is a major annoyance. Nevertheless, this system has been working really well for me, except that it leaves me nothing to tinker with and I’m forced to actually be productive.