To nursing students nearing the end

November 22, 2009 at 3:46 pm · Filed under Nursing school

This time last year I was a mess. I remember it vividly. I was finishing my senior practicum and preparing for graduation and boards. I know from Twitter and the blogosphere that many students are starting to realize “oh crap, I gotta take boards next month.” I WAY OVERPREPARED. I started the summer before boards and did 50 to 100 practice questions per day, and when I actually took the NCLEX I recognized hardly any of the material.

This isn’t to say that my time was wasted, because all that studying has helped me do my job. I’ve remembered a lot of the obscure things they include in NCLEX review but not NCLEX. I am, however, saying that if you haven’t spent day and night cramming NCLEX questions into your head, you probably aren’t hosed. If possible, try to relax a little about it. I adamantly believe that the whole experience would have been much easier on me had it not been for the buildup. They started scaring us about boards the minute we started BSN orientation and just ramped it up from there, and by the time I got to the testing station and started getting fingerprinted and having the body-cavity searches (kidding! or am I?) I was therefore vomitously frightened. I’m pretty sure I remember getting a text from my friend K that she WAS actually puking in the bathroom at the testing center.

I don’t think it needs to be that way. Students, you have survived all the tests in school, and presumably you have therefore engaged your brain. You want to be nurses so you’ve paid attention. Nowadays you’ve probably taken a few dozen ATI tests (I think ATI should be shot and left for dead, but it does have the benefit of attuning you to the screaming annoyance of board questions). You’ll probably be fine.

If not: there are do-overs.

My state does not allow GN status, and I was able to take and pass boards before graduation, so I had about 2 weeks of unadulterated bliss. I had my RN license and just had to chill and wait for the festivities. I hope some of you get that opportunity, because it made life a lot easier.

At any rate: good luck to all of you. Tie a knot in the end of your rope and just hang on: the end is near! In no time you’ll be walking into a patient room and saying, “I’ll be your nurse today” instead of “I’ll be your nursing student today.” THAT is a good feeling. I’m sure I’ll post a “year in” missive when I get there, but I just wanted to play cheerleader for a bit. Cheer. Cheer.

Comments (1)

Moving along in the ER

November 15, 2009 at 11:40 pm · Filed under Health care, Nursing ·Tagged ,

I’m slowly bouncing back from H1N1 and trying to get into some kind of a groove. That flu just kicked my ass. I was actively sick for about 3 weeks and am now still kind of weak. Still, I was able to return for three hard nights in a row and keep my energy up (it was only after that that I slept like a stone). I’m trying to be an unusual nurse and, you know, take care of myself.

My orientation obviously was disrupted by my not going to work for weeks, so I still have another three shifts’ worth. At this point my preceptor is trying with various degrees of success to sit on her hands and let me fly solo. I was alone for 4 hours on Friday, and it was incredibly busy. I forgot some stuff (thank god for unit secretaries, who bring stuff back to me so I can fix it before my errors are engraved forever) and would like to have been speedier, as, I’m sure, the docs would’ve liked me to have been, but all told I kept my head above water and felt pretty good about it. My preceptor called me the next morning especially to tell me I was doing a good job, and that phone call meant the world to me. I don’t care what anyone says: even adults do need external validation from time to time.

The ER is a huge change from everything I learned in the CCU. Most of my patients are on one of two ends of a spectrum: they have a hangnail or they’re dead (we do raise the dead in the ER). I’m used to patients who are pretty sick, but not actually dead, when I assume their care. Conversely, I’m definitely not used to “I’m here because I have a stomach ache/fever/sore throat/runny nose.” What? Don’t people ever just go to bed and rest anymore when they’re sick?

Mostly, in the CCU I was used to getting patients who’d already been stabilized (largely by the ER), so I already knew their history and presumptive diagnosis OR they’d already had an intervention or surgery. Now I’m on the other end, trying to figure out what the heck is wrong and helping to stabilize them. You start from scratch in the ER…big difference from being handed a nice H&P and given report. (And then there’s the matter of learning all the little widgets and gizmos that are needed for splints, stitches, and foreign-body extractions; no, it’s not a myth.)

The cool part about the ER is that I see some truly cool stuff. I saw a stroke patient who came in shrieking with nonverbal confusion and terror, unable to move her extremities at all at one side, and who left for the ICU sitting up on her cart, talking and thanking us for caring for her. This was the miracle of t-PA, which I’d never seen in action before. I’ve seen some dramatic stuff with cardiac drugs, but the t-PA was just almost unbelievable. I think I stood there gaping at the patient, so dramatic was the recovery. The ER docs, the patient’s primary nurse, the charge nurse, and the unit secretary were like stroke ninjas the second they spotted this patient (we don’t keep a CT team in house overnight, so the secretary has to call in necessary personnel), and then everyone else pitched in, and it was impressive. Lurrrrrrrve it.

(Plus, it’s fun to work at a job where staff regularly threaten to kick each other in the junk, but maybe that’s just me.)

Comments (2)

Thoughts on the changing landscapes of social media

November 3, 2009 at 12:55 pm · Filed under Web2.0, twitter ·Tagged , ,

picture1.jpg

I woke up to this status update on Facebook this morning, and it pissed me off (“yay! I’m raising my kid to kill an animal for fun, and I think it’s just fine that the animal may be out there wounded and terrified and alone!”). Which made me unable to go back to sleep. Which made me wonder why I have this person on my friends list to begin with. Which, since I was awake and mad, made me contemplate the changing landscape of social media in terms of where my interests and loyalties lie.

I used to reserve Facebook strictly for people I knew personally in real life. The person above was a childhood friend—it was one of the stereotypical “oh, cool” Facebook reconnections. Since then I’ve been bored by her updates. (I don’t mean to single her out, but this was just a glaring example, so I’m using it as a sort of platonic ideal of “ways Facebook doesn’t blow my skirt up anymore.”) As I lay in bed fretting and tossing (you do that a lot when you’re sick), I ran through my friend lists, and I realized I have a lot of people friended who I really don’t care about at all. I knew them when I was 12 years old, and then I didn’t talk to them for 20 years, and in the meantime we stopped having anything in common. I’m so not interested in a backwoods Missouri deer-shooting Bible-beater now.

So then I realized that, slowly, many of my social media connections have become MORE interesting and important to me than these flesh-and-blood acquaintances. It makes sense, once realized. My social media connections reflect current current interests and commonalities rather than those from junior high. And some of my online connections have become flesh-and-blood acquaintances; in fact, a few have become some of my closest friends. I have made some real-life reconnections that ARE important and interesting to me, and Facebook has been cool for that. Some real gems turn up. I have simply decided to stop reflexively stabbing at the “add” button just because I know someone.

It is psychologically and sociologically interesting to me that I care so little about some people I used to know personally yet keep track of and am interested in the goings-on of people I have never met in real life. I’ve got nursing colleagues scattered across the country and fellow geeks scattered across the globe whom I am truly personally interested in. Some of us even IM and text (if you’d have asked me 3 years ago whether I’d give my phone number to someone I didn’t know, I would’ve emphatically said, “are you nuts?” Of course, Google Voice has changed this landscape as well, but that’s another post).

The way things have been shaking out is I connect with people through their blogs and/or Twitter and then end up striking up so many conversations that we add each other on Facebook, where we get to know each other even better, and then bam. You’ve got an actual friendship. It’s pretty cool. (Some of my Facebook friendships have also started on a more utilitarian basis: Twitter friends I wanted to be able to play Lexulous with.)

Anyway, my POINT is this: I would argue that social media is NOT making us more isolated as a society but is rather broadening our horizons. I have friends in Australia with whom I enjoy bantering about technology, nurses all over the country with whom I enjoy sharing professional challenges and triumphs, and now local friends I probably never would have met without Twitter. I’m paring down my Facebook contacts to reflect people I’m currently interested in rather than people I’ve met at some point in my life. I’m doing this with gulping sighs of relief. No more deer-shootings will have me gritting my teeth.

Comments (7)

For us nightshifters: drowsy driving prevention week

November 2, 2009 at 4:40 pm · Filed under Uncategorized

Drowsy Driving Prevention Week: Nov. 2-8

Can drowsy driving be equated to drunk driving? If you look at the statistics of crashes and deaths caused by sleepy drivers and compare them with those of drunk drivers, it won’t take you long to see the similarity.

The National Sleep Foundation notes that a study in Australia compared various levels of sleepiness with blood alcohol levels and what they found may be surprising. Being awake for:

  • 18 hours equaled a blood alcohol level of 0.05
  • 24 hours equaled 0.10
  • 0.08 is considered to be the level of legally drunk

sleepcartoon_NCIt’s because of numbers like this, the Centers of Disease Control (CDC) is reminding us that November 2 through 8, 2009 is Drowsy Driving Prevention Week. The hope is that a week of awareness may help reduce the estimated 100,000 crashes, which result in more than 1,500 deaths nationwide.

The irony.
I was just ‘complaining’ about feeling drunk after a couple of midnight shifts this weekend .. and I come across this blog!
How eerie.

via mystrongmedicine.com

This increases my happiness that I don’t commute anymore.

From NNR’s Posterous

Leave a Comment

Swine flu: updates on vaccine thoughts

October 24, 2009 at 6:25 pm · Filed under Uncategorized

I’ve changed my mind about the swine flu vaccine (let’s give up on calling it H1N1…it’s not catching on), but it’s pointless for me anyway because I’ve actually had the swine flu. Not the best way to develop antibodies, but I don’t seem to be about to die, so I guess it’s worked out. This flu for me hasn’t been anything to mess around with. The media says either it’s milder than the regular flu or everyone is dying like flies, and at work I see people who are mainly not very sick but are afraid they will GET very sick, so I wasn’t sure what this flu really entailed. It seems pretty different from person to person, but for me it was NOT mild. I’ve never been that sick in my entire life. It was very, very bad for 4 days and is now just kind of bad. I’m weak and still feel like sleeping all the time.

I had a sore throat and body aches on Sunday morning, so I took some Tylenol and slept all day. I felt crappy but went to work Sunday night, where I lasted only 3 hours before I was hit with shaking chills and had to leave. It happened THAT FAST. I barely made it home, I felt so bad. I took my shoes off and crawled in bed with my scrubs on. I had my husband pile all our blankets on me and just lay there and shook with chills. I told him I wasn’t afraid of the flu epidemic anymore because I now knew I would feel so sick it wouldn’t matter to me if I died or not—I remember that clearly! Otherwise that started a few days of in-and-out feverish crud. I got nauseated and had the GI stuff that’s associated with this flu. I had a scorching sore throat and a ripping cough that made me want to cry. I was maxed out on antipyretics and my fever was still 100 for a few days. Then I started having trouble breathing and was worried about pneumonia, so I actually put a mask on and went to the doctor: secondary bronchitis infection.

It’s now Saturday, almost a whole week in, and I slept almost all day because I am just. Worn. Out. I went in to this with maybe not the most stellar of immune systems, but I’m a relatively healthy chick. I can see how any chink in the immune armor would have made this a lot worse. I can easily see how people are ending up in the hospital. One night I was having such trouble breathing I had dreams of being in a cool-mist oxy tent and again of having a cooling blanket.

I’ve also heard from my ICU nurse friends that healthy 30- and 40-year-olds are dying of H1N1 complications. This contradicts what I’d heard before about it being people with underlying conditions. I’m getting a bad feeling that the public is not being fully informed. Anyway, I’m now suitably scared and respectful of the swine flu, and I recant my previous objections to the vaccine. Maybe not recant, because I think my opinions were valid, but I reserved the right to change my mind with more information, so I’m doing that.

Thank goodness my new employers have let me off work with only wishes for a speedy recovery. I would be frantic if I had been that sick and lost my new job on top of it!

Comments (5)

Social media policies in health care: are they going too far?

October 12, 2009 at 8:35 am · Filed under Health care, social media

Picture 1My workplace, like many others, has put us on notice that they’re developing an official social media policy. In the meantime they spoke sharply about stuff we should avoid posting about (room numbers, diagnoses, and obvious stuff like that). I wish this weren’t necessary and that healthcare professionals would not need to be told this sort of thing, but, fortuitously, the day before the notice I had e-mailed a friend on Facebook and encouraged her to knock off some of the stuff she was posting (no, it wasn’t me who ratted people out!). But I guess it is necessary, and I strongly support institutional social media policies—otherwise the waters are deep and murky for those of us who blog (and almost everyone uses Facebook these days).

The thing that bothers me is that a lot of companies seem to be pushing these policies too far. I haven’t seen the policy for my job yet because it’s still being hammered out, but it does sound like they’re going to say we can’t say anything at all about our jobs (“had a long day today”) or that might reflect badly on us as 100% upstanding individuals (“stayed drunk for 32 hours during my week off”) or we’ll get canned, the reasoning being that we’re constantly representatives of the company. I don’t think posting stuff like that is a good idea, and I’m not sure why people WANT pictures of themselves drunk on toilets with their pants down on Facebook (it’s a disturbingly common sight), but there is a very fine line here.

What’s the difference between such a policy and one that says employees can never go to a bar on account of people might know they work at XXX company? Can our workplaces police our activities when we’re not there, outside of HIPAA violations? Indications are that they are going to try, on grounds that they can cite “unprofessional conduct.” What will be considered “unprofessional”? Who will decide? Will the conduct have to be egregious? Will the violations be spelled out? Is social media going to render us on the clock all the time?

I am troubled at the reactionary clamping-down of social media in the healthcare sphere. I support some of it, because clearly some people need a reminder that we should not be identifying patients online, and they keep doing it, so there apparently needs to be a framework in place to stamp that out. I just hope hospitals think it through before getting too draconian about it. First, although we work for someone, we still have freedom of speech, and that’s worth protecting. Second, social media can be extremely helpful and productive for healthcare professionals, and stamping it out is NOT helpful or productive (I also would argue that this will just drive bloggers into the anonymous underground, where HIPAA will not be scrupulously observed). Third, allowing co-workers to communicate on Facebook promotes team unity and a better at-work environment; stilting that interaction by forbidding anything that could possibly be construed as nonprofessional is probably nonproductive.

I suppose we’ll see. I haven’t yet worked anywhere that had a social media policy, and I’ve always thought they should have, so that there is a clear expectation. It’ll be interesting to see how far they go.

Comments (4)

I knew my skepticism was well founded about this flu shot business

October 8, 2009 at 2:36 pm · Filed under Uncategorized

Distributed for peer review last week, the study confounded infectious-disease experts in suggesting that people vaccinated against seasonal flu are twice as likely to catch swine flu.

via theglobeandmail.com

Yes, it’s anecdotal, but I’ve been sick ever since I got my flu shot and have had a bad feeling about all these quickly approved vaccines. Unpatriotic or no, I am VERY DUBIOUS about both flu vaccines this year.

From @not_ratched

Comments (5)

Ping! woes, SMS, Facebook system, Snapture

October 6, 2009 at 8:49 pm · Filed under Photography, iphone apps, productivity

I should stop writing glowing reviews of iPhone apps, because apparently I’m the portent of doom. As soon as I do, they start sucking. In Ping!’s, case, battery life. I wasn’t doing all that much Ping!ing, yet my battery life dropped to about a quarter within a few hours. That along with suddenly ALL duplicates and a lot of error messages led me to junk it. I’ll add it back if it improves with the next release.

Meanwhile, I bit the bullet and shelled out an extra $5 to AT&T for unlimited SMS, which I’ve resisted on principle. It’s so CHEAP to send SMS (for them; consumers are hosed). Also I wish I could pay less for my voice plan, which never gets used. We seriously have 3000+ rollover minutes. I’ve been holding out for that reason and because I had high hopes that iPhone push would replace a lot of the stuff I have traditionally used SMS for, such as notifications. It has for some things. I used to have my Twitter DMs come to SMS, for example, but now push totally replaces that and does a better job. I can just open the Twitter app right up and reply. Many fewer steps. Otherwise, there are issues, because if I get more than one push notification, some of them get lost. Usually this isn’t a big deal, but if they’re reminders for things, then I go unreminded. So I’m returning to SMS notifications for, eg, Google Calendar reminders. Tried and true.

My friend @smartassredhead also told me about her Facebook system of getting SMS alerts for her fave peeps, thus avoiding having to mess with the hell hole that is the Facebook Web interface while still keeping in touch. I tried it. I like it. It’s far more sophisticated now compared to when I tried it before. You can just start texting to comment or like a post: no muss, no fuss. In addition, I spent an hour with my Facebook friend lists and made a shorter list of people for whom I really am actually interested in everything they post. I called it “GASA” (give a shit about…I never said I wasn’t cynical). This cuts my Facebook time-wasting about in a third. If I want to catch up on what my high school acquaintances are doing when I do have free time, I can look at my “High school” list. I don’t need to know what they’re doing all the time, but it’s nice to have the option. And yes, I realize it’s jacked up NEED a “Facebook system.” Deal with it.

Back to SMS. I have Beejive on my iPhone and Adium on my desktop, and no one will IM with me on either one, so I always end up back at texting. I am also one of the apparently few morons (according to the podcastosphere) who actually like MMS, so I’m psyched I have it now. Yes, I can e-mail pictures, but it’s much faster and easier to MMS them, plus my husband doesn’t have e-mail on his phone (not everyone does). Indeed I don’t check my e-mail all that often comparatively, because I figure if it’s important someone will text me!

Now I’ll kill off another iPhone app by recommending Snapture, which I used when it was still a jailbroken app. It costs $1.99 now but will get more expensive. It has features like zooming and leveling that are handy, I guess, but I like it because you can set a smaller resolution default size and use the entire screen as the shutter button. I don’t need giant photos for snapshots I’m going to e-mail or MMS to someone. I have my iPhone set to open the camera with a double-click, but Snapture sits in my doc, ready to fire up for a super-fast snapshot. It can take three rapid-fire pics as well. Then you can e-mail from within the app with a swipe. In other words, tap, swipe, e-mail, you’re done. Nice. Now tomorrow I’ll probably have to post saying it suddenly stopped working.

Leave a Comment

Ping! for iPhone…get it while the gettin’s good

October 4, 2009 at 10:24 am · Filed under iphone apps

I say that because Ping! (App Store link) was free and now it’s $0.99. It looks to be one of those Very Popular Apps. It’s made it to my home screen. It’s a direct iPhone-to-iPhone chat/SMS client. See a demo video here:

It is head to head with What’sApp, which is getting better ratings but has some downfalls. They both do, and they both cost the same. Ping! occasionally suffers from duplicate messages and screen flashing, but I’ve experienced no connection issues, and it’s FAST. Like poo-through-a-goose fast. It also doesn’t require you to give out your phone number to your chat buddies as What’sApp does; that might be a big deal to some people (it isn’t for me, because if I’m unsure I give out my Google Voice number, which can later be blocked).

No app is perfect, but this one is a good buy for a dollar. That’s what, 10 SMS messages worth? I bet I’m not alone in having a NOT unlimited iPhone messaging plan. Using Ping! frees up quite a few SMS messages for my contacts who don’t have iPhones (like my Luddite husband). If I could interest more people in IM, Beejive would accomplish the same goal, but my friends tend to never use IM, so I just quit starting up Beejive…

This post has wandered a bit, but the basic point is that this a good app with a few bugs that are probably being hammered out even as you read (the developer has a page on Facebook and seems very responsive), so if you have an iPhone and have friends who also do and whom you can strong-arm into spending a buck, go do some buying and strong-arming.

(E-mail me for my Ping! ID, although I bet readers can guess it without too much difficulty.)

Leave a Comment

Nurses file lawsuit over mandatory flu vaccine | KOMO News - Seattle, Washington | Local & Regional

October 3, 2009 at 7:11 am · Filed under Uncategorized

Nurses file lawsuit over mandatory flu vaccine | KOMO News - Seattle, Washington | Local & Regional .

I wondered when this was going to happen.

Leave a Comment

Older Posts »