Too Fat 4 Ponies BSN RN

"Pain... oh... if I have to rate it... 4 out of 10?"

2009-12-12T22:48:00.000-06:00

I was working the other night when we had a walk-in chest pain in his late 50s. He had been sleeping when he woke up to what he described as indigestion.

Turns out he was having a full blown MI. We got him shipped out to the cath lab quickly.

Found out later he had 6... yes... SIX lesions... three of which were 90% occluded!

He told me he hadn't been to the doctor in over 20 years. Not on any medications up to that point.

Poor guy couldn't be stented. Emergency CABG.

Wow!

Pistachios and Jelly Beans: an observation

2009-10-17T00:01:00.000-05:00

Thursday night I started my shift by bringing a bag of pistachios and a bag of jelly beans to work. Preferences were absolutely defined by gender. Females preferred jellybeans. Males preferred pistachios.

Interesting.

My New Hangout

2009-10-16T17:37:00.001-05:00

I was at the county clerk's office today to get tags transferred over to my wife's Isuzu when I came across a gem of a custom remodel.

A blue Chevy Geo converted into a truck. The disappointment comes from not getting my iPhone camera out fast enough to take a picture.

I believe GM could have staved off bankruptcy had they only created vehicles such as the Chevy Geo truck. It's hauling capacity alone just screams 3 cylinder power!

My next day off might be spent at the DMV or county clerk just so I can snap pictures of custom cars ;)

Unbelievable...

2008-11-15T14:32:00.000-06:00

Rutherford County citizens are outraged and embarassed.

The next Rutherford County School Board meeting is December 11, 2008 @ 5pm. Parents should voice their concern over this principal being in charge of children.

The Murfreesboro Post should be boycotted for their editors not doing their job!

Thank GOD for decent men such as Colin Powell

2008-10-20T00:00:00.000-05:00

JibJab

2008-10-10T15:16:00.000-05:00

Try JibJab Sendables® eCards today!

Race Matters

2008-10-09T14:33:00.000-05:00

The national news is overwhelmed with a discussion of race and the upcoming election.

The sheriff of Lee County Florida recently gave speech while in uniform at the podium for the McCain-Palin ticket. This is clearly unprofessional behavior but it is also a violation of 'the Hatch Act'. Had he appeared in a private citizen capacity he could have avoided a guaranteed federal investigation.

It is painfully clear that McCain and Palin are directly and indirectly inflaming racial tensions in their recent rallies. Up to this point I have had great respect for McCain as a war hero. But I feel he is AT LEAST standing by and letting hate speech take over his campaign. McCain is demonstrating he is willing to do anything and everything to win. Even if it means he solicits the racist vote.

We are already experiencing the trouble from electing the dumbest President in history. Do we really want to risk another dumb President if McCain dies in office? Palin is a partisan hack with no brain.

... and we're back

2008-10-06T11:04:00.000-05:00

Let me get the updates out of the way.

Mom in-law is doing okay with her oral chemotherapy. Other than reduced energy levels the side effects have been none existent. Unfortunately we had to hospitalize her this past Friday for pneumonia she developed from the virus going through our entire family (thanks to our youngest's Pre-K class). She initially refused to go to the hospital.

Thank god for the home health nurse. It makes no difference having a nurse in the family. I am still her son in-law. She listened to the home health nurse... who by the way, read her the riot act! She is doing better now and we expect her to come home 'from hospital' (nod to the Brits) tomorrow.

Our oldest started back to school in 1st grade and our youngest started Pre-K thanks to the new TN lottery money! They are currently on their two week fall break (alternate school schedule).

I'm loving working in the emergency department. The ED has a great crew and it couldn't be in a better environment to work and learn. The down side is that now that I'm on my feet more I've been having more problems. In addition to pain I started to lose sensation in my toes.

Heidi has been great by offering to massage my aching feet at night and I bought some expensive running shoes with arch supports. Relief was modest. In late August I went to my first ever podiatrist appointment.

My podiatrist diagnosed me with fasciitis, heel spurs, and falling arches. NO DIABETES (for those of you concerned). The falling arches didn't surprise me as I've had feet problems all my life. You should see the size of my right heel spur... wholly hang upside down from a tree branch BATMAN!

My doc recommended buying custom orthotics which relieved some of the fasciitis and all of the toe numbness but didn't do much for the heel spur pain. He also recommended buying a pair of Z-coil shoes which if you've ever seen a pair... look a bit dorky.

SO NOW I'M A DORK! I went to bed last night for the first time in months with zero pain. Best money I've spent yet.

Novartis Patient Assistance... what a joke!

2008-07-26T04:20:00.000-05:00

So I have been slacking in the posting department. Sue me.

I'm writing out of anger today. Just being honest.

*Gripe alert*

So mom in-law has needed to move in with us in early spring while she battles her breast cancer. She has put up the good fight with chemo, radiation, and mastectomy.

Yesterday we took her to the oncologist with concern. She has developed nodular areas on her back and the doc confirmed the worst. The cancer has spread. A PET scan has been ordered. We will find out the rest after the scan.

Have you heard the term 'when it rains it pours'?

Once we got home there were several messages from her various pharmacies letting her know that all of her medications are now going to be full cost as she has fallen into the infamous Medicare part D for 'DONUT HOLE'. This includes her oral anti-cancer agents.

We called back to the oncologist and they were able to switch some things around so she would be taking her drugs in his office to allow Medicare part B and her secondary to pick up the tab. Great! But this did not fix all of the problem.

My mother in law takes Fumara (a hormone treatment) for her cancer and it is still in the donut hole. We were told by the doc's office to call Novartis to enroll her in their "Patient Assistance Program". So I called.

After listening to the automated operator direct me through various "press this button for this" and "press this button for that" I finally made it to a human being. Or so I thought.

The Novartis representative asked me all sorts of questions about my mother in-law... SS#... Medicare #... DOB... monthly income... blah blah blah. Then she asked me about my income and my wife's income. I asked her why the hell did she need to know our income since it was my mother in-law who needed the assistance.

She just smugly responded, "We have to factor in all family member's income to determine who qualifies."

"So if I had a twelve year old son who cut grass in the summer you are telling me that Novartis would factor that income into this program?"

"Yes."

"F**king incredible! Of course we would pay for your drug if WE could afford to buy it for her but this IS the 'PATIENT Assistance Program' is it not?! I hope you and your CEO are able to sleep at night."

Silence.

"Maybe you idiots at Novartis might consider being more honest by renaming your crappy PR scheme to 'FAMILY Assistance Program'".

Go USA!

Wow!!!`

2008-05-31T15:55:00.000-05:00

I have been offered a position in the Emergency Department!

Remarkable Inspiration

2008-04-09T23:55:00.000-05:00

Good Policy or Paternalism?

2008-01-01T20:04:00.000-06:00

The Nashville area hospitals (including mine) are all implementing policies for the new year to stamp out smoking completely from their campuses. That means NO SMOKING ever anywhere on campus. Nadda!

I absolutely loathe smoking and I agree with these new policies. I can't stand smoking and feel bad for individuals who are addicted (most of my family included). Hate the sin but love the sinner.

When we think of NO SMOKING policies most of us immediately think of acute care settings. Its no big deal to have the physician order a nicotine patch.

But what about long term care units where the hospital is also a home? Is it fair to deny patients the right to have a vice? Keep in mind long term care patients have access to outside smoking areas away from non-smokers.

In this instance is no smoking paternalism?

For your consideration. Think about a vice you may have and substitute it for smoking (social drinking, sports gambling, overeating, etc). How would you feel if choice was no longer an option for you?

Let me know your thoughts by leaving a comment.

Two Double Oohs & 8

2008-01-01T12:32:00.000-06:00

Okay. So this is the only mention. I haven't posted in a long time. So I forgive myself and have moved on. LOL

What has Too Fat been doing all of this time?

Vacation. My family has gone without for so long while I changed careers that I OWED them a nice vacation. We bought an off season vacation package to SeaWorld & Busch Gardens (Florida). The kiddos loved it (even though they were too small to ride most of the rides). I have to give the theme parks some credit. They had sections specifically for the younger set. The wife enjoyed the time away from normal life. We spent a couple of days on the beach collecting shells before making our way home. It was a fun vacation and I can't wait to take the next one.

Re-fi. In the midst of the mortgage industry slump we managed to get a re-fi on our home to pay off some old debt and new (from nursing school). Yay!

Work... work... work. Work is moving along. Our census is up (lets hear it for job security) and staffing numbers are slumping. Lets hope the 'powers' get their act together and hire some more staff. Otherwise work is going well. I work on a good unit where 95% of the staff get along with one another and inter-unit fighting is kept to a minimum.

Winter Solstice. We attended a winter solstice party hosted by some friends of ours. We haven't been able to socialize as much as we liked to over the past couple of years so it was nice to see our friends again. Unfortunately they are moving to Georgia so we wish them the best of luck and hope they won't be strangers on their way back through to visit nearby relatives.

Christmas. Being the RN with least seniority on the unit I was lucky to have gotten Christmas Day off. The weekend leading into and Christmas Eve were filled with 12 hour shifts so I was pretty frazzled by the time the night of Santa's visit required LOTS of wrapping and tucking under the tree. Morning of went fine. We had a lot of fun and the boys got most of what they wanted (I am a firm believer in not getting EVERYTHING!). Grandma spent the night and was able to share the morning events with us (despite her lap dogs barking all night at Santa!). LOL. We had to miss the my family's big holiday get together but hey... there is always next year.

I am going to try and write more often. If I don't then I think it may be time to consider taking this blog down. We'll see how it goes in 2008.

Happy New Year everyone!

Too Fatt

Awesome!

2007-10-31T23:53:00.000-05:00

iPod schmipod

2007-09-20T10:18:00.000-05:00

3 weeks post 1 year warranty
iPod stopped working
called Apple support
"sorry. no repair available"

just satisfying my curiosity now

rot in hell Apple, Inc.

Not so much a guy thing...

2007-08-29T08:53:00.000-05:00

I LOVE being an adult again with a real job!

Recently I bought something that at first blush had my wife rolling her eyes. I am the proud owner of a brand new DeWalt 12" Miter Saw... (insert Tim Allen-esque grunting here). It is by far the nicest power tool I have ever owned. Lowe's was having a sale and it just happened to fall in the same week as a 'freed up' paycheck.

Now the stereotypical thing to write might be... 'it's a guy thing'... but you don't run in the same circle of friends that I do. One of my good friends just so happens to own plenty of power tools and has a workshop... and... just happens to be a wife and mother of two.

So the possibilities are endless. I am constantly thinking about projects that need to be done and projects I would like to do. Now I have to get some lumber in here and start sawing away!

BTW, my wife stopped rolling her eyes once she realized that 'miter saw' equates to "New Front Porch Railing," "Backyard Deck," "New Flooring," and "New Privacy Fencing."

Can't wait to call up my friend so we can break it in!

Recalls... Recalls... Recalls...

2007-08-23T17:38:00.000-05:00

It would make sense with all the recent Chinese made product recalls that one would like to stop buying 'made in China'.

Good luck with THAT!

EVERYTHING is made in China.

We are going to be as careful as we can this coming holiday season. Of course we will try to buy 'made in USA' and other countries whenever possible. One suggestion you may like to try is to purchase toys online.

A recent article by ABCNews is complimentary of the online companies notifying customers directly through email of recalls... which is something the rest of the retail industry is sorely lacking.

Being a nurse, former database administrator, and a parent makes me, I think, uniquely qualified in stating that retailers could easily use existing barcode/database/marketing technology to do a BETTER job of notifying consumers of recalled products.

If you think this is a good idea then I suggest you do what I have already done. Contact your representatives and demand the same thing. Sure would be nice if a Presidential candidate would jump on the bandwagon... but then of course that would mean less corporate donations pouring in from retail political action committees.

Ups and Downs of the Younger Set

2007-08-23T15:11:00.000-05:00

We just got home from picking Seth up from school. And it was an interesting ride home.

"Poppa?"

"Yeah?"

"I got a red check today."

"What for? What did you do to earn a red check?"

[silence]

"Seth?... Tell me what you did."

"Someone got a red marker this morning at home and put it on my calendar."

Needless to say we had to get home and dig through his backpack to read the note the teacher left. Seems that after almost a month (3.5 weeks) of green checks... the kiddo had a bad day. Basically it boiled down to not listening to the teacher and causing a distraction to others.

As I write, Seth is in his room for the rest of the day.

"Poppa?"

"Yes?"

"If I get a green check tomorrow do I have to stay in my room?"

"No. If you get a green check tomorrow you will get to ride your electric motorcycle, play Xbox or Wii, and watch cartoons."

"Poppa?"

"Yes?"

"I don't like staying in my room."

Now he's getting the idea.

Guess its best he learns this at the start of the school year. At least he'll know for the rest of the year what punishment will be in store for him at home for anymore red checks.

On a brighter note... (aka Kicking your nemesis while he's down)
Ben has been semi-potty trained for a while. He'll take the initiative to go pee-pee in the potty but won't go poo-poo. That is... until today.

After Seth got his punishment handed down Ben started hollering from the bathroom. I figured he needed help with his pull-up. Nope. The little guy left Poppa a huge present!

We celebrated and he was thoroughly congratulated.

I'm thinking the younger is trying to show up the older... lol!

Which would you prefer as president?

2007-08-23T09:55:00.000-05:00

The dry-drunk frat boy that we currently have (i.e. GeeDubyaBush) OR the class smartass?

I prefer the class smartass... at least there is some intelligence there.

Only in the mood to surf...

2007-08-22T20:47:00.000-05:00

I visit a friend's blog regularly and also visit his link to Post Secret... check them both out.

Birthday Par-TAY!

2007-08-12T01:50:00.000-05:00

Our youngest turns 3 today but his party was yesterday... in the backyard... in the heat!

We had a good time. My wife and I rented a 'Go Diego Go' bouncy castle and we setup a couple of shelters to keep the sun off of our 20+ guests. The kiddie pool was setup under the main shelter and the kids thrashed around getting everyone & everything WET! Despite the heat I think overall it was a good party.

Ben got lots of presents thanks to our good friends. He is big into "mals" (his word for animals) and I'm not sure if it is due to his liking the show 'Go Diego Go' or if it preceded the show. But either way he racked up.

The big present (from Momma and Poppa) was the battery operated four-wheeler. His older brother got a battery operated Harley at his 3rd year party... and now it was Ben's turn.

I searched for another Harley and couldn't find one so we had to settle for another 'type' of motorcycle. Either way it will be a fun ride. One thing is for sure. The new toy was a hell of a lot easier to assemble than the Harley. Now comes the long wait (18 hours) to charge the battery.

Maybe I'll buy a rapid charger?!

Wii have a Wii

2007-08-01T23:17:00.000-05:00

That's right. I thought I should let you know that my sorry ass couldn't wait any longer to get one. Besides. My birthday is around the bend.

Confession time. I've been trying to hunt one down for a couple of days now. They retail for $249.99 (very reasonable as far as consoles go) and nobody had one. Sure I could have bought one off of eBay for 2-3 times the retail price but I refused.

Then today I just decided to call some of the businesses I hit a few days ago to see if they had any shipments arrive. BINGO! Toys R Us said they had a few but they couldn't hold any due to the demand.

I rushed right down. Into the store I went and WHAMMO! I was crushed to read a sign as I entered the gaming department, "Nintendo Wii Sold Out".

DAMN!

So I went up to the customer help desk to ask when another shipment would arrive. TRU associate 'Brad' quickly told me, "We aren't sold out. Actually we have six!" He went on:

"And for some reason they aren't selling as quickly as past shipments."

"Could it be the signs you have up telling customers you are sold out?"

"Oh yeah! I guess we should take those down."

Ah yes. I too remember those days of minimum wage retail work. It sucks!

Now even the most hardened critic (namely my wife) succumbed to the hip-ness generating from the console known as Wii.

I've owned many consoles over the years and have tried many, many more. My younger brother is a Playstation II fan while I was (kinda still am... just not as much) and Xbox fan. But the Wii is like no other. It is really good family fun.

We set it up tonight to play. The wife, our oldest and I played bowling while the youngest cheered us on enthusiastically. Its like having a bowling alley in your home. The disc packaged with the console also included tennis, baseball, golf, and boxing.

One of the other nice features I like is that the Wii came ready to connect to my Wi-Fi network without having to purchase additional hardware (unlike my Xbox). Once our bank account recovers from this purchase I'll use the Wii to surf online to their store and download some classic Nintendo games.

There are several channels preloaded. Most require an Internet connection. Forecast Channel, News Channel, Wii Shop Channel, Photo Channel and then there is the Mii channel. A Mii is a neat little way for you to customize your online player (body type, facial type, overall appearance) to use in your games and online community.

A free channel I downloaded is the Voting Channel. Its a fun little channel that lets you vote on various polls setup for the Wii online community.

I'm really digging this little white box. Its looks are deceiving. Anyone familiar with computer hardware might mistake it for an external CD/DVD drive. But there is a lot more in there than a disc reader.

"You are sweating like a... a... well... you are sweating a lot."

"Thanks honey. Now you know the FAT reason why I bought the thing!"

I Gotta Wii [pronounced: "wee"]

2007-07-30T19:38:00.000-05:00

Not really. But I do have access to a Nintendo Wii. The unit I work on has one for the residents and about every other shift or two we get it out to play bowling or tennis with them.

If you haven't figured it out by now... I am a game console nut. The only thing that has slowed me down in the past couple of years has been the expense of nursing school. I WILL OWN ONE OF THESE CONSOLES VERY SOON!

It is more than a game console. Just calling it a game console doesn't do it justice. It gets us couch potatoes off of our fat duffs and makes us exercise. I almost have to bring an extra set of scrubs to change into because I sweat so much.

So for all you parents out there concerned about the kiddos lying around watching television and gaining weight... go get them a Nintendo Wii. They will be exercising without realizing it.

Of course make them go outside too!

Making It All Work...

2007-07-29T05:34:00.000-05:00

Tomorrow will mark another chapter in our family history. Our oldest will begin his first full day of kindergarten. He is definitely ready.

"Poppa? I like my teacher."

"Yeah?"

"She's pretty."

So young and already has a crush on teacher.

I spent one late night recently preparing for his first 1/2 day of school. My wife called me at work before hand to let me know when I got home my job was to write his name on every marker and crayon.

"CRAYON?!"

"Yes. On every Crayon."

"That seems a little OCD don't you think?"

"Just do it."

"You bought the fat Crayons right?"

"No. They have to have the box of 24 regular size ones."

So there I was after a 12 hour shift at the kitchen table spelling his name out umpteen zillion times. It was easy arranging those tiny bits of matter once I got the electron microscope up and running. Did I mention I had one of those?

The school is very nice and well designed. They have a separate entrance just for the kindergarten wing. So parents don't have to wade through traffic for the whole school when its time to drop off or pick up.

Seth's classroom has what is basically a giant play tower in one corner. I was very impressed with the whole thing. It looked like a great place to have fun.

Another change we are making is having grandma be our primary daycare provider. Lets hope this works out. We have wanted her to have a closer relationship with the boys ever since she moved to town but her bout with cancer (now in remission) soon after she moved had prevented her from doing so.

Its the life of a working nurse with a busy family life!

Reading Can Be Enjoyable?

2007-07-07T03:03:00.000-05:00

My wife gave me a Hasting's gift card for Father's Day. Today, on my way to pick up the kids at daycare, I stopped in with the goal of finding A BOOK!

This couldn't be just any book. It had to be a fun read.

Late 90's B.C. (that's... Before Children) my girlfriend-slash-wife asked me to go to see one of her favorite authors perform a public reading of his latest book. My thought at the time she asked me was something like... "this will strengthen our relationship..." or something like that. I wasn't expecting a good time. To my surprise it turned out to be a fun experience.

David Sedaris had us rolling in laughter. Tears were literally streaming down our faces we laughed so hard. If my memory is correct the excerpts he read were from Me Talk Pretty One Day.

The one Sedaris story that stuck with me from his reading described how, as a kid, his family hosted a big family cookout. After waiting in line for a long time for his uncle to free up the one bathroom Sedaris discovered a present had been left... and the remainder of the story had to do with Sedaris trying not to be blamed for the present that 'would not flush' no matter how many damn times he tried!

Today I purchased Dress Your Family in Corduroy and Denim. I've gotten through the first few chapters and chuckled the whole time.

Good read.

BTW, David Sedaris is the brother of Amy Sedaris of Strangers with Candy fame (Comedy Central show).

BellSouth has joined the new AT&T...

2007-07-06T12:33:00.000-05:00

"Welcome to the new AT&T!"

"... your bellsouth email address that you have been using for the past 8 years has been mistakenly deleted from our system."

The new AT&T smells a lot like the old AT&T.

To Clarify...

2007-06-17T09:45:00.000-05:00

My new job started several weeks ago and I am amazed at the lack of knowledge regarding levels of nursing.

Studying the history of nursing was very interesting, for me, and it also clarified why there are so many ways to become a nurse.

Practical Nurse (LPN/LVN) was brought about because of the U.S. government/military lack of available registered nurses; education is received through technical schools (traditionally); sits for NCLEX-PN

Diploma RN - the oldest method to RN; educated through programs associated with a hospital and not a college or university; these programs are being phased out (TN last diploma program closed in 2006); sits for NCLEX-RN

Associate RN (ADN/ASN) - educated through a 2 year program (usually a junior college) and was brought about (by forces outside the profession) due to a shortage of 4 year registered nurses; sits for NCLEX-RN

Bachelor RN (BSN) - educated through a 4 year college/university program; sits for NCLEX-RN

Did you know that Florence Nightingale was the first to call for nursing schools to be associated with colleges and universities and NOT hospitals?

I wonder what the discipline of medicine would look like today if it had as many outside forces manipulating the profession of Medicine?

One more thought...
True. There are various ways to become a nurse and multiple ways to become a registered nurse. But please do not discriminate against the new grad BSN due to 'lack of clinical experience'.

The discipline of Medicine expects (and treats) its new MDs to have limited clinical experience and accommodates the learning curve.

Nursing should have the same level of expectation and professionalism.

Remember when I said...

2007-06-12T00:37:00.000-05:00

"If the opportunity arises I think I would make a pretty good RN?"

That is how I broke the news to my wife in the spring of 2005 that my no good company was eliminating my position. And I started a new chapter in my life.

One of my former bosses once made a comment to me, "All I have to do is give you a goal and you make it happen." I took her compliment and lived it by enrolling in an accelerated BSN/RN program.

I was able to manipulate my company into paying me for NOT doing any work (not even walking in the door). It was fairly easy since I hadn't written anything down about the systems I developed were saving them millions of dollars each year... AND THEY NEEDED WHAT WAS IN MY HEAD!!!

Twelve months later (translation: guaranteeing my yearly bonus... and a few more benefits the company did NOT want to give me) and I parted ways with the bastards. It wasn't easy since I had a little more than one more year to go in the nursing program. But my family and I survived and WE succeeded.

Graduation was May 5, 2007. I scheduled NCLEX (state boards) June 9, 2007. Today I received the news that I passed my state board!

I can officially refer to myself as a registered nurse.

Too Fat
BSN/RN... thats R-N!!!

I PASSED BOARDS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

2007-06-11T16:44:00.000-05:00

WOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO
<*huff-puff*>OOOOOOOOOOOOOOOOOOOOOOOOOOOO!

more fun

2007-05-19T23:15:00.000-05:00

Ha-ha!

2007-05-18T16:37:00.000-05:00

That was fast...

2007-05-14T11:42:00.000-05:00

I just accepted the job I interviewed for on Friday!
Woooooooooooooooo!

They have a program to pay off my student loans!
Woooooooooooooooo! Woooooooooooooooooooo!

They have a program to pay for my grad school!
Woooooooooooooooo! Woooooooooooooooooooo! Wooooooooooooooooooo!

I'm a goofball.

Diagnosis Wenckebach

2007-05-14T09:02:00.000-05:00

Better Day

2007-05-12T07:37:00.000-05:00

Yesterday I went to an interview. I don't want to write too much about it because I want the job and don't want to hex myself. Let's just say the feds really know how to run an extended care facility. Nice!

Cross your fingers.

The actual interview was a challenge since all of the questions were geared towards nursing experiences. Being a new grad made it a challenge to reflect back on my clinical experiences. I even had to think about my past job somewhat. I really want this job.

Culture of Idiocy

2007-05-10T20:26:00.000-05:00

This is not a pleasant post so if you are expecting good feelings ... stop now.

**GRIPE ALERT** GRIPE ALERT**GRIPE ALERT**

So I haven't been writing for a while because of school wrapping up, studying for boards, and starting a new job as a graduate nurse.

I've been looking forward to working at the local hospital for quite some time now. During my junior year I applied for a nurse aide position. At the beginning of my senior year I applied for a nurse extern position. In February, I applied for a graduate nurse position. After each application I followed up with the H/R department to see where my application was in the process.

"We've filled our nurse aides positions."

"We tend to hire [local university] nursing students for our extern positions."

"We can't find your graduate application."

So with some unexpected intervention from a friend of my wife's (she works for a hospital in the same system as the local one) I was able to get an interview and I accepted a position.

Eating Their Young...
All of the this past week I have been in orientation. I am the only male in the class (not unexpected) and I am the only graduate nurse (everyone else are RN or LPN).

Now you might think I am being paranoid but I have been singled out at every opportunity during orientation. Each training session begins with a very poignant reminder from the instructor to me (in front of the entire class):

"Now [you] will not be able to do any of this until [you] are licensed."

Fair enough. Understood. Gotta get the legalities out of the way.

But then the reminder is repeated before each topic throughout the day. Like, I'm an idiot?!

Today was the last of four days and I have reached my limit. Our schedule was disrupted as we were invited to come hear our friendly CNO make a presentation. This meant we returned to our training room 10 minutes before going home. The (recently hired) 'nurse educator' whipped out a twenty-five question exam to finish before going home (half clinical math and half NCLEX).

I have to admit I panicked a little. I was expecting a clinical math test (no problem). I wasn't expecting NCLEX questions. In addition, the 'nurse educator' walked outside people into the room while we were taking the test and loudly talked to them and asked us several times:

"Aren't you done yet?"

So I turned in my test and watched as she quickly graded the tests. She handed a few back and as she did I couldn't help but notice there were one or two RNs with 4 to 5 questions marked wrong in red ink. As the nursing educator finished mine she stated:

"[My name]? What floor do you work on? I may need to go speak with your manager."

During the whole process of grading and handing back she never called out anyone else.

She handed my test back and I missed three... out of 25!

Oh. And I answered the additional two ER/ICU/CCU mcg titration math questions correctly (so that is out of 27).

Bad Culture
This hospital has recently brought in a new management team. I was hoping to be part of that change in culture. But you know. I am not going to be part of a culture that is only interested in maintaining the 'status quo'. Let them still favor only one of seven area nursing schools. Let them continue with the reputation of second class care (I've lived here since 1989... I can give you an earful).

Yeah. This has been a week of harassment. And this has been a week of discrimination.

I'm turning in my resignation tomorrow.

With the exception of boards....

2007-04-25T18:21:00.000-05:00

I just passed my LAST nursing school exam!!!

Woooooooooooooooooooooooooooooooooooooooo!

Mom's Nursing School Photo

2007-04-22T18:05:00.000-05:00

Gone Fishin'

2007-04-21T15:44:00.000-05:00

Took my oldest fishing today.

It was his first ever fishing trip and my first as a parent.

We went to Wally-Mart last night to shop for supplies. Tradition was over before it began. Seth was immediately drawn to an end cap full of the latest fad contraption for kids. You might be familiar with the Rocket Fishing RodTM as it is currently being advertised on the boob-tube bragging a 30 foot cast with each fire of the trigger. There was no convincing him of a traditional fishing rod & tackle. I tried bribing him with a Spiderman tackle. The kid wasn't having any of it and I caved.

He was up with the sun this morning as I was greeted with a smiling face and an unopened Rocket Fishing RodTM IN MY BED! To say that the kid was excited does not do him justice. We eventually got out the door and on to our new found fishing spot.

I have to admit it has been several years since I fished and it took a few tries at tying a hook properly to a line but I eventually knocked the 'rust off the old gears' and managed. The fishing contraption seemed to be working fine and Seth was as happy as a clam. That is, he was so happy that every 2 minutes he was reeling the line back in so he could "shoot" it out again.

We had several heart-to-heart talks about scaring fish away and he seemed to settle down. After an hour with no nibbles I decided we needed to change spots. There was a bridge off in the distance (about a mile) but it was well worth it.

The center of the bridge was the perfect spot to fish as we were getting nibbles immediately after casting. Within minutes he and I were both reeling in fish. We had to release both as they were too small to keep. After another round or two of catch and release the boy was yelling:
"POPPA, POPPA! The bobber is GONE!!!"

Sure enough I looked down and the huge bobber from his fishing contraption was completely taken under. I figured it was tied up on the pier so I told Seth to start reeling in the line when suddenly a bass the size of my leg came flopping to the surface. Our eyes got HUGE! But the stupid fishing cannon malfunctioned and he was not able to reel in the fish... it kept releasing line and that smart fish wrapped himself around the base of the pier about 3 times. The bass eventually snapped the line and got away. Seth and I were very disappointed.

It seems this fishing contraption is good at catching small fish but big fish are too much for it (despite what the commercial says).

Oh well.

Seth was happy to catch a croppie a little while later.

Everything is on course...

2007-04-20T07:54:00.000-05:00

My apology for not writing in a while.

Everyone is doing fine. We did change to a family practice physician and could not be happier with the new doc. Our littlest guy will be going back in another couple of weeks to be re-evaluated for enlarged tonsils and possibly a referral to an EENT. Wow! A practitioner who knows how to listen and take care of a patient.

For the most part school has heated up considerably and is the reason why I haven't written in a while. I managed to finally complete my clinical hours in the ICU and am just now re-introducing myself to family and friends (chuckle).

The ICU was by far the most interesting clinical rotation I've had thus far. I managed to not have any actively dying patient assignments during my entire time in this program. That is until my last day when I had two. Neither passed during my shift but it was interesting to be working with the family and I learned a lot about myself when dealing with one particular patient.

The patient that was the most challenging was younger than me and with children around the same age as mine. The diagnosis was grim with metastasized colon cancer resulting in an inoperable brain tumor. I choked up every time I entered the room to see the youngest child sitting and coloring at bedside.

I definitely hugged my wife and kids a little tighter that night.

On the brighter side....
Just passed the most comprehensive standardized test to date (school's assessment tool) and had to pass in order to graduate. Most of us were given two chances to pass but I didn't want to leave anything to risk so I studied my gluteus maximus off, took sample tests, and entered the bargaining phase (oh lord... I will dedicate my life if only I can pass this test!).

Happy to say that I passed the first time and it was 14 points above national average! Woo!!!

The next hurdle is an upcoming Advanced Topics comprehensive final (ugghhhh) and then its on to May 4th pinning and graduation on May 5th.

Oh... then there is my 20th high school reunion coming up next year.

The Angry Sailor

2007-03-08T20:20:00.000-06:00

Scare of Our Lives

2007-02-17T18:34:00.000-06:00

Our two year old experienced a seizure earlier today and scared us all to death. It wasn't until we were riding in the ambulance and half a mile from the ED that he started coming around.

I have never been more happy to hear Ben cry!

There were a lot more details that I could share about the experience of seeing him seize... but I choose not to (right now) because otherwise I would be a blubbering heap of snot. I will say this. I am so happy that my little guy is okay now.

The doc came in and told us he suspected a febrile seizure and had ordered blood draws, a chest xray, and a urine collection. Ben's temperature was 100.4 before he got his first dose of Tylenol.

After a few hours it was determined that Ben had a minor ear infection but the doc was not confident that was the source of infection. Chest xray and urine came back negative. But his WBCs were slightly elevated.

A Rocephin drip, a script for Omnicef, and we were on our way home.

It is one thing to read about febrile seizures out of a textbook. It is something entirely different when you are experiencing one for the first time... and its your own two year old.

My thanks goes out to the paramedics, nurses, and docs at MTMC ED.

Now I am off to bed!!!

Update:
The following Monday we took Ben to the pediatrician but could only get him in during the 'sick clinic' they hold every morning from 8 to 9am.

The doc who saw him was the same that the ER doc consulted via phone (not his regular doc but same practice).

Doc came in... slammed the chart on the table... regurgitated the past weekend events (as if I hadn't been there... duh?!)... looked in his mouth and states:

"Your son has viral pharyngitis and not an ear infection."

"Are you going to swab his throat?"

"No need. I've seen lots of these. He'll be over it in three days."

Update-Update:
Today we took Ben to his regular doc (who we have NO complaints about) and THIS TIME he was actually assessed (throat swabbed).

Results: S-T-R-E-P!

What the hell good is holding a 'sick clinic' when the only thing anyone gets out of it is a doctor who gets a copay for misdiagnosing/undertreating... while we have to return multiple times to get the same instance of illness TREATED?!!?

This is the same practice that misdiagnosed our son's pink eye.

The count for this office: 3 in a row misdiagnoses or undertreatments

This IS the final straw. We love our regular pediatrician but because we cannot always see her we continue to get shoddy care from her cohorts.

I am calling a Family Practice physician tomorrow to see if he is accepting patients.

Singin' the Praises of Modern Technology...

2007-02-11T23:00:00.000-06:00

With the recent changes in our extended family and the need to keep in closer touch with my mother in-law, my wife and I were in a dilemma.

We are in the home stretch financially with nursing school and the funds are thinning fast! We have no long distance on our house phone but we do have DSL Internet.

What's a poor student who loves technology to do?

Skype is an online Internet phone service owned by Europeans.

We went to their site, downloaded their free software, upgraded service by paying the annual fee (not monthly) of $30, and now we can call any phone in the US or Canada unlimited for a year.

So this goes out to my fellow nursing students who are trying to make it financially. Skype is a great inexpensive way to keep in touch with those living at a distance (just don't use it for emergencies... no 911 service).

Hope I saved you a buck.

Enjoy.

before Depart. of Education!

2007-02-09T21:00:00.000-06:00

a sad day

2007-02-05T12:42:00.000-06:00

Last week my father in-law lost his battle with prostate cancer when he died 1925 January 31st at the age of 82. He had been married to my mother in-law for an amazing 58 years, fathered five daughters, grandfathered 11 grandchildren and 7 great-grandchildren.

"Bert" described himself as a simple man. He raised and fed his family through income he earned as a commercial sign painter (a lost art). Bert painted billboards in Chicago for over 30 years and in Sevierville/Pigeon Forge/Gatlinburg (TN) for over 10 years before retiring in his 70's. He was an amazing guy that defined the meaning of a hard days work and had a great sense of humor.

I've been present for 4 deaths and his was the first where I was actually holding someone (giving meds) as they died. My sister in-law is an amazing nurse as she provided a majority of his care over the past few months. It was an honor to assist my sister in-law with his care in his final hours. I will never forget the experience.

You may have heard of people 'waiting' to die. Until this experience I did not put much belief in that way of thinking. But now I am a believer. Even up to the very last hour Bert was asking for people to come into his bedroom to see him. The few times he was able to recognize his surroundings he spent trying to make us laugh by cracking a funny face. It was truly amazing and I have never seen anything like it.

Here's to you, Bert.

As he liked to say... "See ya later!"

iPod?!... Here iPod?!

2007-01-13T23:47:00.000-06:00

Call it a misguided gift... call it not knowing my wife... whatever. Last year I bought my wife an iPod thinking she might like to use it as she commuted back and forth to work everyday.

It sat on her dresser for about a month after she opened it. I tried to get her interested in it by setting up an iTunes account for her. No dice. I tried showing her how to use it in the car. Again, no dice.

So with her permission I started using it to upload my recorded lectures to listen in MY car. Yeah. Go ahead. Accuse me of giving her a gift just so I could have an iPod. But I SWEAR that wasn't the intention.

You're giving me that look of disbelief.

After using it for an entire semester I became rather attached to it. Once the Camry died I had to start toting it around (rather than conveniently leaving it in a car). And it was the last couple of hairy weeks of fall semester when it came up missing.

I searched high and low for the darn thing thinking it fell down in the couch or got misplaced in the house somewhere. Once finals week came and went without it turning up I started thinking I lost it in someone's car (from bumming rides back and forth to school) or I lost it at school (which I had little faith in seeing it again).

Another theory I had was that my oldest got his little hands on it (as he has been known to do such things) since he too has an addiction to all things gadget (like his father). He has been known to order movies on the satellite system (the wife and I don't order movies... and nobody has ever shown him how to do it).

Two days before school started I drove up to school to post a reward sign on the department board in the hopes that one of my theories was correct and I could recover it.

Tonight my wife walks into the kitchen as I am unloading the dishwasher... WITH THE iPOD!

"Where the hell did you find it?"

"Under a pile of YOUR crap!"

"Oh man! I am so happy to see it again."

"Try cleaning your side of the bedroom and maybe you won't lose it again."

Point taken.

She so enjoyed telling me that.

Arrr!

2007-01-13T13:25:00.000-06:00

My pirate name is:

Mad Sam Roberts

Every pirate is a little bit crazy. You, though, are more than just a little bit. Two things complete your pirate persona: style and swagger. Maybe a little too much swagger sometimes -- but who really cares? Arr!

Get your own pirate name from piratequiz.com.
part of the fidius.org network

It Feels Like A Monday

2007-01-10T17:47:00.000-06:00

So late yesterday as I was going to pick up my boys from daycare my stomach started cramping... and I mean CRAMPING!

I had just finished eating a salad with a new no fat dressing and assumed it was the fat substitute that was giving me GI problems. But seeing that I am into my second day of nausea and stomach cramps I think it is safe to assume I have a stomach virus.

The whole point of mentioning the goings on of my gastrointestinal tract (sorry for subjecting you to this) is that I was up and down several times last night with nausea and pain. This sucked badly since today was my first day of class for the new semester and due to the lack of sleep the night before... I managed to NOT hear the alarm clock thereby making me 45 minutes LATE to Advanced Topics class!

Thats enough of the crappy news. Now for the good stuff.

I have been awarded a preceptorship in the MICU at Vanderbilt!!! Weeeeeeeee!

:-)

Now I am going to contain my joy by laying helpless on my couch eating saltines and drinking ginger ale.

Night. Ugh. :-(

End of Shift... latest edition
http://www.emergiblog.com/2007 /01/change-of-shift-volume-one -number-fifteen.html

Fans of Soichiro

2007-01-07T20:28:00.000-06:00

We traveled to Weaver, Alabama (Anniston) over the weekend to visit my older brother and his family. He is a lieutenant on the Anniston police force and his wife is a nurse practitioner. My niece is in her first year of high school and is too funny. We love them dearly.

During our visit my brother told me that a buddy of his is a salesman at the local Honda dealership.

"Lets go see what he has on his lot."

Hopes were not high since my budget was too small to consider a Honda but I thought it would be fun to get out of the house and do some car shopping with someone who enjoys car shopping (namely my brother).

Before we got there the salesman told my brother over the phone that he had a 2002 Escort that was in my price range. Now normally I wouldn't consider buying a Ford since my first new car purchase was a 1988 Escort (aka 'piece of junk') but desperate times call for desperate measures.

Warning: my wife refers to the following as 'My Ford Rant'
Within a few months after purchasing the 1988 Escort the paint started cracking and literally falling off of the car! The dealership only agreed to repaint the car after I threatened them with legal action. But that isn't the worst of it.

The 88 Escort stayed in my possession for 3 additional years. About every 6 months the timing belt would snap off of the damn thing! It would cost $120 each time a new one had to be put back on. My favorite story with the car was when I was traveling down to visit my older brother when a minor bump on the Interstate triggered the fuel line shut off valve (aka 'stupid' Ford idea to prevent more exploding economy cars... remember the flaming Pintos?). I was stuck on the side of the Interstate for several hours until the nearest dealership (Chattanooga) could come and tow the car back to reset the valve. Due to warranty, only the dealerships were allowed to reset the valves. It cost me $280!

It was a few years after the car left my possession that NHTSA forced Ford into releasing internal documents that stated that the year model Escort I owned was designed with faulty engine mounts resulting in a motor that was out of balance causing timing belts to prematurely snap. Of course NHTSA didn't have the authority to make Ford reimburse their customers and Ford didn't offer.

So this is for any corporate employees of Ford out there who are wondering why their recent efforts to turn the fortunes of the company around are not working.

FORD HAS BEEN TREATING FIRST TIME CUSTOMERS LIKE DIRT SINCE 1988!

Corporate types like to blame the whole thing on the cost of union labor but that isn't the sole reason why Ford is going under. Ford is producing cars that are second rate and are not designed with the customer in mind. Enough said.

Back to Car Shopping in 'Bama
By the time my brother and I arrived at the dealership the 2002 Escort had been sold. So I test drove a 1999 Dodge extended cab mid-size pickup truck. I have to admit it was nicer than I thought it would be. It had a 6 cylinder engine and I liked the additional power (considering the 4 bangers I usually drive).

Then the salesman showed me a 2000 Honda Accord SE. It handled nice but it was waaaaay out of my price range. The salesman told me he would see if he could get the price knocked down a second time.

I didn't hold my breath.

After about 10 minutes he returned with a deal too good to turn down. They had come down $1600 off of the sticker price... about a quarter of the total asking price!

Deal.

The wife thought I was pulling her leg when I called to tell her I was bringing back a Honda Accord. Earlier in 2006 we had to buy a car out of desperation (and yes... it was a Ford... I said DESPERATION!). Her exact words were:

"Not only is it a Honda... it isn't another Ford!"

Heh.

We arrived home about two hours ago and let me tell you... the Honda drove like a dream!

Most Bizzarre

2007-01-04T17:34:00.000-06:00

This afternoon as I watched the Simpsons I witnessed the most bizarre 'commercial' I think I've ever seen. I don't even know if you can classify it as a commerical. It is at the very least bizarre.

Its a soap opera serial for a well known Nashville attorney. The only message I get from it is 'acting classes are for wussies!'

In my opinion, someone has chased too many ambulances and stopped short!

Most Hated

2007-01-04T01:41:00.000-06:00

There is only one thing I hate worse than going to a dentist.

And that is shopping for cars.

Ughhh!

Getting Recharged by the Suns

2006-12-30T05:35:00.000-06:00

Christmas On The Road

2006-12-26T22:24:00.000-06:00

We spent the holiday at the inlaws. It is the first time since my wife and I started a family that we spent Christmas away from home. Last year wasn't that great of a Christmas with the loss of the job and being nervous about spending money. This year was not as stressful financially but then we had our minds on the health of another.

My father inlaw suffers from prostate cancer that has metastasized and is in the final stages (kidney failure, pulmonary embolism, you-name-it). I have to give him great respect. He has definitely made decisions about his own health and has not allowed 'things' to happen to him.

He turned down surgery 10 years ago when he was first diagnosed and so it has been 'watchful waiting'. Until this past year, when the cancer spread, he had refused chemotherapy and radiation. The chemo and radiation therapy he finally accepted was palliative and has bought him some time. He has ABSOLUTELY defined how his final days will be spent.

My father inlaw is in his eighties. If he was younger when he was first diagnosed I think everyone around him would have been more insistent with the radical prostatectomy but... like I said... he is a fiercely independent individual who fights every ounce to stay in control. It has only been this past summer that he ALLOWED me to cut his grass for the first time (for cries-sakes). He does not like anyone doing anything for him.

A Need for Humor
My inlaws live in what I call "the Las Vegas" of the Smoky Mountains... Pigeon Forge, Tennessee (less than 2 miles from 'Dollywood'). As a kid, I lived not that far from the real Las Vegas so I think I am qualified to draw some similarities here. Maybe not for the gambling aspect but definitely for the electric signage.

In the past year, roadside advertisements for a new show, Miracle, have popped up and I have to start making smart ass comments as soon as I see them (my wife really hates it).

"Has the religious right become so good at predicting political outcomes that they now can predict the precise moment a miracle will occur... and put it on stage?"

"A lightening bolt is going to hit this car if you don't stop!"

"I gave my only begotten son... so Joe-Bob can make a buck selling tickets & renting cabins."

"GOD?! I'm only married to him. Please do not smite me down along with him... I'm just along for the ride."

"Man! I would HATE being Jesus' understudy for THAT show."

"Will you stop it?"

"Think of the money they save by not having a special effects technician... they don't need one."

"STOP IT!"

Too bad the lady who sold her 'Virgin Mary in a Cheese Sandwich' for $28,000 didn't think about opening a show in Pigeon Forge. She could have made millions!

But don't worry. I understand she keeps it close to her heart by having it tattooed on her bosom.

THATS security!

2006-12-21T19:29:00.000-06:00

I purchased a replacement battery for my laptop about ten minutes ago using my bank check card.

Five minutes later I received a phone call from my bank checking to see if my purchase was legitimate.

WOW!

How is that for security?!

Heh!

Road Kill in Reverse

2006-12-18T19:06:00.000-06:00

I beg you to go to this link and read how the Tennessee Titans rely on EVERY member of their team (that includes the mascot) to win games.

We feel bad for the injured Saints player but my wife and I were rolling on the floor with tears streaming down our faces... we laughed so hard reading the smoking gun report.

End of Semester.. oh and then theres my mother

2006-12-16T10:13:00.000-06:00

Alas! My last day of school was yesterday. Wooo!

On the whole, this semester was the most difficult I have had thus far. The summer course load was more difficult than this one but with other things going on in life... the fall has been more difficult overall.

Our Camry exploded two weeks before the end of school so that just added additional stress to the regular school load. I was a mere 200 miles shy of 200,000 miles on the odometer when WHAAAAAMO! It threw a rod and the resulting explosion left a 10 inch diameter hole in the engine block. And I JUST had the damn thing worked on over the summer. So much for Toyota reliability.

Its amazing how resourceful and creative you have to become getting two kids to daycare and getting yourself to class 30 miles away when you don't have a vehicle! I was fortunate to have a fellow classmate that lives less than 5 minutes away and a few others nearby to help me tote the kids back and forth to daycare.

I traveled to Lawrenceburg today (hometown of Senator/Actor Fred Thompson & Deceased actor Michael Jeeter) to take possession of my brother's spare vehicle. Its a 1976 Ford F150 with about 300,000+ miles on it. Ha! I had the chance to drive it a few years ago and let me tell you... a 3 speed on the steering column manual is not the easiest vehicle to drive! But hey... I am very lucky to have a great brother to loan me a vehicle in my time of need. I'll try and post a picture.

This past week I took four final exams, two comps (must pass), gave a presentation, and submitted my research paper. All without a vehicle. Oh yeah... I mentioned that. I took a dive on the Med Surg II final and for the first time in nursing school made a 'C'... I'm still working with my therapist to accept the reality of a C. I'll keep you posted about my progress (being a smart alec here).

Flight of the Hypochondriac
Postponed a trip out of town yesterday to take my mother to the emergency department. For those of you not in the know, my mother is a grade A world class hypochondriac with a subspecialty in drama (and she's a retired diploma RN to boot).

She called me in the afternoon while I had both boys at home to tell me that her systolic bp was 190. Well that certainly raised an alarm with me.

"That is stroke territory, Mom."

"I know. I'm waiting to hear back from the doctor."

"So you placed a call?"

"Yes."

"Well call them again and tell them you need to speak with him immediately. Call me back and let me know what he tells you."

She didn't call me back until an hour later.

"My systolic is over 220! They told me to get to the ER as soon as possible!!!"

"Let me wake the kids from their naps, load them in the car, and I'll be right over to take you to the ER."

It was while I was gathering everything (including children) into the car when it hit me. She had told me that she had quit taking losartan and started taking a new ARB (can't remember the name) the same day. Plus she just bought a new electronic bp machine.

With my student nurse senses tingling the last two things I grabbed before racing over to her house was my stethoscope and my manual cuff. I had every intention of double checking her bp against her electronic bp machine.

When I got there she had what seemed like her entire retirement community standing in her driveway... with her at the center. I was amazed that she was waiting for me in her driveway.

"I want to take your bp manually to make sure that new machine you bought isn't malfunctioning."

"We don't have time! I'm going to stroke out!!!"

And with that I was met with about 5 sets of ugly glares from her neighbors. So I quickly made arrangements for her neighbor to babysit my kids and I went back inside to grab her bp machine because I knew it had stored her readings and thought it could possibly help the ER doc/nurse in treating her.

As I walked back to the car I was met by another angry neighbor with, "You just need to get her to the ER, NOW!"... this from the same neighbor that told me she couldn't help babysit my kids because she had a dinner date.

And off we went.

Along the way Mom made several proclamations that included such statements as:

"I hope I don't have a stroke before we get there."

AND

"If I don't make it, please make sure my dogs are taken care of."

So I'm taking her pulse and checking her respirations as I am driving the 5 miles to the hospital. Pulse was 80 and a little bounding but that is normal for her since she has heart disease. Her respirations were 18. Her extremities were warm and she wasn't diaphoretic.

As I drive by the emergency department entrance I notice that the paramedics are rearranging the ambulances and have completely blocked the entrance so I drove a little ways past them to park.

"What are you doing?!" She asked as she spun her head around in amazement.

"I'm parking. The emergency room is within 50 feet."

"I'm too weak to walk that far."

"I'll help you and if I have to get a wheelchair I will get one."

No sooner had those words left my mouth, the car had barely come to a stop (I still had the keys in the ignition for cries-sakes!) when she bails out and starts RUNNING halfway across the street... by herself!

So I catch up with the in-VAH-lid to help her the remaining 20 feet to the emergency room entrance when she spots a wheelchair and immediately plopped her keester into it. I wheeled her the remaining 10 feet to the admission clerk's desk.

The admission clerk was not having any of it. My mother was giving the performance of her life that included out of breath responses and new claims of nausea and headache. They wheel her back and hook her up to the Dyna-Map machine... 149 over 89.

"That really came down," she stated.

"Yeah, with all the running, screaming, and crying who would have guessed your blood pressure would go DOWN!" I added.

They gave her a number and we were hauled off to the waiting room.

During our tenure in the waiting room she entertained me with laughing and telling funny stories.

All I kept thinking was, "You have lost your freakin' mind lady!"

And that is when I remembered her electronic bp machine. I went and retrieved it from the car and plugged it in. I noticed it had an easy slip on cuff designed for older people. I slipped it on as recommended and it gave me a normal reading... 132 over 86. I decided to turn it around and take it again... 187 over 110.

Me thinks I've solved the mystery!

Mom and I had a long talk. It was a long talk about relying on electronic bp machines without double checking with a manual reading.

I'll spare you the remaining 4 additional hours of emergency room time but I will share this with you. I checked her bp on the dynamap in the examination room two times... 148 over 88 and 140 over 86. The last reading before we headed for home was 130 over 80 (BETTER THAN MINE!).

And my wife and I are out $70 for our hotel reservation that we couldn't use.

But I love my crazy mother... and you can too for just the cost of a Greyhound ticket I can ship her off to you for the holidays!

Just kidding... sort of.

No Holds Barred Politics

2006-12-10T09:26:00.000-06:00

My New Lexicon

2006-12-09T18:19:00.000-06:00

My First Video Blog

2006-12-03T14:28:00.000-06:00

Change of Shift

2006-11-30T15:46:00.000-06:00

The new Change of Shift is up at Fat Doctor this morning! It's Volume One, Edition Twelve!

http://fatdoctor.blogspot.com/2006/11/change-of-shift.html

Postive Attitude

2006-11-29T23:52:00.000-06:00

Theme: Having a hard time keeping a positive attitude these days.

Philosophy: I've decided not to write much until I get myself out of this funk.

Excuse: Our good old Toyota Camry blew up today (literally) and I'm draining whats left of the retirement fund to get a replacement.

Apology: Sorry. Swore I wouldn't go negative but... hey!

Excuse #2: In dire need of a break from school.

Happy Holidays (or 'Merry War On Christmas' for you Bill O'Reilly fans)

1st day back... WHY?!

2006-11-28T09:30:00.000-06:00

Self Loathing
I am sitting in PEDS right now on a break and realized that I missed a question on my quiz because I did NOT read the stupid question correctly.

The diet for children with PKU should include vegetables and fruits.

I read the question too quickly and misinterpreted 'include' as 'exclude'. Nothing but a poor reading of the question on my part. It also didn't help that I was in a rush this morning trying to get here on time.

Family Relations
We spent the holiday weekend with the in laws. My father in law is suffering from metastasized prostate cancer and is undergoing radiation therapy. He is a fiercely independent person who has rejected aggressive treatment since he was first diagnosed SEVERAL years ago.

I am impressed with his attitude towards his health. He is doing about as well as anyone I've known with cancer and 'the mental attitude'.

A Bit of Good News
My med-surg clinical instructor wrote to tell me that she is impressed with my latest care plan and will be presenting it to the dean to see if I qualify for a preceptorship next semester. Woo!

Keep your fingers crossed. I would love to work in a critical care unit, burn unit, cardiac unit, etc.

Armstrong & Aldrin
The boys got haircuts last week which were long overdue. The wife took them in last Sunday while I was 'picking up' my patient for my last med-surg clinical.

With the way my schedule works out I go about 36 hours without seeing my family starting noon on Sunday until Monday evening (when I pick the boys up from daycare).

So I'm driving home from my Monday med-surg clinical and I called the wife on the cell.

"I'm out of clinical and going to pick up the boys."

"Wait until you see them."

"What do you mean?"

"They cut Ben's hair waaaay too short."

"I'm sure it looks fine."

I sensed that I should have held my tongue on that last comment when I realized she developed a little quiver in her last statement.

Once I saw them I thought Ben's hair looked great. They both had buzz haircuts but it was Seth's hair (the four year old) that I had the problem. The person who cut his hair gave him bangs that looked like Jim Carrey in the movie "Dumb & Dumber".

It was at the dinner table I finally got sick of looking at it.

"Did the same person do both haircuts?"

"No. The younger stylist cut Seth's."

"Boy. It looks it!"

With that I left the table and started fishing out the never-used accessories to my electric beard trimmer from under the bathroom sink.

I have to admit I felt like a mad scientist. I wasn't sure if I would be successful but I sure was going to face the wrath of my wife if I wasn't.

After several tense moments with my oldest sitting on a chair in the bathroom and my running the beard trimmer on TURBO across his noggin... I was done. I thought it looked much better but I knew my opinion wasn't the one that counted.

I am happy to report that my wife was pleased with the result (and I get to keep all my fingers, toes, and limbs)!

We are Dan Zanes fans

2006-11-11T18:09:00.000-06:00

'Mine Eyes' are Opened

2006-11-11T15:22:00.000-06:00

My wife and I tease each other frequently about our ancestor nationalities. Hers being German and mine being Celtic (Scotch-Irish-Welsh... mostly) we have some interesting quips back and forth (usually instigated by me).

Not long after our first son started to learn how to walk he did this funny walk across the living room floor. He did a straight legged goose step that cracked both of us up. I couldn't resist by teasing my wife with, "I guess that's his German genes being expressed."

"No. I think its his way of keeping you from putting him in a 'skirt'!"

To which I reply, "It's a KILT not a skirt!"

My other favorite 'back and forth' is when one or both of the boys lose their temper. I'll snicker, "Its that German temper."

"Oh yeah... and the Scots are known for their EVEN temperament! Doesn't the U.N. use the Scots for peace negotiations?"

Yeah. I know. Sounds pretty sick but we have fun with it.

The latest is our four year old at bath time. If you aren't careful and get soap in his eyes during the rinse cycle (despite using tear-free shampoo) he will yell out, "MINE EYES, MINE EYES!"

Both of us struggle to get his eyes washed out without appearing to laugh because he sounds just like the German guard on "Hogan's Heroes" (go look it up if that pop culture reference throws you).

I swear its all in good fun. Please don't send DHS to our house.

Childhood Illness Update (aka my latest rant)
**WOOP-WOOP-negativity alert - WOOP-WOOP-negativity alert**
Two weeks ago our four year old developed a small rash above his left eye about the shape of a nickel. It was red, raised, and a little dry. My wife and I started treating it with some neosporin thinking it might be a skin infection.

Several days later the rash was looking a little better but then the two year old developed what looked like conjunctivitis in his right eye.

PINK EYE ALERT!

And off to the doctor we went. Of course our pediatrician was out of the office and we had to see "the substitute".

During the 45 minutes in the waiting room I had time to think about how busy this pediatric practice has become since we started using it four years ago. It has gone from 3 doctors to 6 and you can always expect a packed waiting room anytime you go.

So we were finally called back to the examination room. The nurse checked the boys' weight and height and took their history. I remember feeling rushed.

The doc arrived and I repeated my concern that we had a case of conjunctivitis going through the family to which he replied,

"No. The two year old looks like he injured his eye and the four year old can't possibly have conjunctivitis since conjunctivitis doesn't go outside the eyelids. [The four year old] has contact dermatitis. This is all just a coincidence."

"Are you sure that the same organism causing the rash isn't the same causing the red eye?"

He just gave me a look of I'm-the-doctor-so-quit-second-guessing-me.

So we were quickly handed a small tube of ointment for the four year old and a script for gentamycin drops for the two year old with the instructions:

"Use the ointment on the four year old now and give the two year old a few more days to see if this clears up. If it doesn't clear up, go ahead get the prescription filled and start using it."

"Is there an ointment or oral med we can use since it is VERY difficult to get eye drops in a 2 year old?"

"No. There is nothing else but this."

(Right. Like I was born without a drug book in my book bag.)

From the time we arrived in the examination room to the time we left it was less than 7 minutes.

After the doc visit I called the wife to share the news, took the kids to their daycare, shared the news with the daycare owner (she uses the same pediatrician we do) and off to school I went.

We did what the doctor recommended. The ointment cleared up the four year old's rash. We waited a few days to see if the two year old would clear up. By the third day we knew we had some kind of infection since it spread to his other eye and started using the drops... FOUR TIMES A DAY! The drops seemed to work but the redness never went away completely.

Fast forward to the middle of this week and my wife calls me at school to let me know that the daycare owner is disputing the doctor's findings (three of her kids now have red eyes), needs to take her children to the pediatrician, and can we please pick up our boys.

Later that same day our daycare lady called to let us know that our shared pediatrician was back in the office, immediately diagnosed all three of her kids with conjunctivitis, and gave her an oral antibiotic to use! And according to her report from what our pediatrician stated, "Organisms that cause conjunctivitis can present in older children and adults as a rash above the eye."

(Slow burn...)

My question is this. What the hell good is building up a medical practice if you are so busy that you can't do a thorough assessment?!

MY GOD! CONJUNCTIVITIS HAS TO BE THE MOST BASIC DIAGNOSIS TO MAKE!

And no. The substitute doctor we saw the first time was not fresh out of residency. He was semi-RETIRED!

It isn't because we have a beef with our regular pediatrician but rather it is because we now have had two experiences (the first, six months ago) where our regular pediatrician was not available, we were rushed through an examination, received a wrong diagnosis, and ended up with even sicker children that we have decided to go elsewhere.

Its sad. We like OUR pediatrician and if she were in practice by herself we would stay.

**WOOP-WOOP-negativity alert is now over**

:-) peace in the valley once more

The Downfall of the Repugnants

2006-11-11T15:06:00.000-06:00

The Democrats have both houses!

Not a single Democratic incumbent lost a seat.

The Repugn-icant Party is where they belong... out in the cold.

I know I'm a little late in celebrating but I've been busy.

Letterman Slams O'Reilly

2006-10-29T11:26:00.000-06:00

With the mid-terms approaching... I'm in a political mud slinging mood.

Ouchies, No-no's, and To-go's

2006-10-28T18:38:00.000-05:00

My PEDS clinicals went off without a hitch. My last clinical ended two weeks ago. It wasn't as many hours as I thought it would be. I wouldn't mind going to a few more (just no more care plans, PLEASE!). It definitely helped to be a father of two kids.

The first clinical had me taking care of two 7 year olds. A boy and a girl. The boy was recovering from Rocky Mountain spotted fever. He went home an hour into my shift and I was very disappointed since I had no experience with RMSF. The 7 year old girl was a post appendectomy.

No real challenge since she and her mom were very pleasant. Pain care with lots of distractions and the day was over. Turned out my patient liked watching 'Handy Manny' (also a favorite of my oldest son) so I could speak 'intelligently' about how Turner is okay but Squeeze and Stretch are my favorites.

During my second clinical I took care of a 11 month old with C. diff and assisted with a 5 year old post tonsilectomy. The morning assessment of the 5 year old went off without a hitch. As I left the room I asked him if he wanted a popsicle or anything else. He said, "yes, I want you to go."

Sweet kid. He'll grow up to rob a convenience store, I'm sure, but for now... SWEET KID!

[chuckle]

The 11 month old was more of a challenge. Not because of the patient. Not due to the contact precautions. You guessed it. I actually donned gloves and gown to answer a call light to the 'tune' of momma asking, "Can you get me a Dr. Pepper?" Her favorite soap opera was on TV, she had a bottle propped in the patient's mouth (I know... there is only so much education one person can ignore), and she didn't want to have to leave the room "I might miss something."

Find a happy place.

Find a happy place.

Find a happy place.

Oh, if only we could require licensure before one is allowed to be a parent!

The last patient assigned to me was a 4 year old with asthma. This one held a special place in my heart since I too was a kid with asthma. She was a funny kid. At morning report her O2 sats had hovered around the high 80's. The breathing treatments from R/T helped to bring her sats up to 97% but that would only last about 30 minutes. Then it would be another 3 1/2 hours until the next treatment.

An education session later and a few reminders to turn, deep breathe, and cough and I felt a little proud to see her sats come up from 89% to 92-93% territory.

My clinical experience was well worth it. Everyone I go to school with wants to go into OB. Not me. I could easily work with the kids.

We had one student report her LPN clinical in PEDS involved going to daycares. No hospital clinicals at all. Yuck!

It doesn't matter who you are...

2006-10-28T00:32:00.000-05:00

... reading the chapter in Pediatrics on terminally ill children will get you choked up.

If it doesn't make you shed a tear then maybe you aren't human.

For those wondering. I'm still here... just having to move priorities around.

Too Fat, SN

Weird Al - Canadian Idiot

2006-10-15T10:59:00.000-05:00

Too funny. Before I get comments please note that Al's song is really about what is wrong here in the good ol' USA. Love the song, love the original (Green Day's American Idiot), and love the video.

"Jesus Loves Me...

2006-09-02T04:06:00.000-05:00

But He Can't Stand You."

[Disclaimer: If religion is a sensitive subject... this post is not for you]

My subject and first line is a title to one of my favorite all time songs. Its a stab at the self righteous by the Texas bluegrass band, The Austin Lounge Lizards. The story is told through the perspective of a hyper self righteous individual who believes he is so close to Jesus... he talks to him on the phone every day. It is sung to the traditional tune, "Jesus Loves Me This I Know."

Hum along with me.

Don't get me wrong. I respect the right of others to believe what they may. Live and let live is my motto. In fact, some of my best friends are quite the religious types. With that said there is a select group of individuals in our society that take pride in letting you know how much closer to Jebus they are... than you are!

Which brings me to the point of mentioning The Austin Lounge Lizards. Their song played in my head this past week during Med Surg class. The room is relatively small and I kept experiencing one, then a second, and finally a third person bumping my laptop as I was typing away at the end of class. I forgave the first incident, started to get annoyed at the second, and said, "EXCUSE YOU!" to the third. They just kept walking by... after barely acknowledging a problem with a look back.

"Jesus loves me this I know... and he told me where you're gonna go... can't you feel those hot flames licking yewww ewwww ewwww." [more lyrics]

All three students went immediately outside the door in the hallway to form a circle with twelve others for a group prayer (I call them 'The Apostles'). This is the subpopulation within the class that do not talk to you unless you go to their church. Seriously. They sit around talking about the stupidity of others. And boy do they take themselves seriously.

My type of humor does not go over well with them. I know. I've tried. It has something to do with the use of the word 'penis' in the punch line. [Chuckle]

"I'm raising my kids in a righteous way... so don't be bringing your kids around to play... your kids will grow up stoned, left-leaning, and gay." [more lyrics]

Makes me wonder how these students got accepted into nursing school and what kind of nurses they are going to be when they come across a patient not from their culture (subculture even). Oh my! I would love to be a fly on the wall during that assessment and subsequent lawsuit.

Its a sure bet that they will fail the culturally competent care questions on the NCLEX!

Getting Personal
I've had my turn at the organized religion thing. My father was a devout Mormon and my mother was raised Catholic. I'm one step down from the comedian, Rosanne Barr (who was half Mormon half Jewish). And I even lived in Utah for several years (sorry Utah Mormons... not trying to bash).

Religion is a very powerful force. When not practiced with care it is like juggling lit sticks of dynamite. I've personally witnessed the destructive force religion can play on all levels (personal, family, community). I've witnessed the shunning of the societal other and survived the blowing up of a marriage... all in the name of religion.

Don't get me wrong. I have great respect for other people and their beliefs. This post isn't a bashing of religious views (or my parents beliefs). One doesn't go through what I've experienced without coming out the other side with a broader world view and healthy respect for others.

These days my family (extended) is like the U.N. of religion.

It has taken me a long time (several years) to come to peace with my own relationship with a loving God and her ability to heal. For me, religion isn't the answer. Its spirituality. This is what works for me.

Be mindful.

The Real Problem
Now all I have to do is devise a mechanism to protect my laptop during class. I'm thinking about velcroing a BIG black magic marker (facing out) to the back of my laptop. Or maybe I should get some sharp objects. What do you think about razor wire?

God knows I'm just kidding.

(Go check out my next favorite Lizards tune... its a bluegrass cover of Pink Floyd's Brain Damage)

Culture Shock

2006-09-01T03:45:00.000-05:00

Today was our first day of classes (second day of official semester) and what an eye opener. Up to this point I've been part of a small accelerated class (16 to 20). Well, today we caught up with the folks ahead of us and man is it a BIG class!

The only thing I can compare it to is high school. There must be close to 80 people. The noise of chatter before class and during breaks is enough to make me want to buy sound proof headphones. What were they thinking putting this many people in one room?!

Ear plugs and finding a 'happy place' is definitely now part of my strategy. [Chuckle]

Med Surg II Clinical Assignment
I hit the lottery!

The clinical pool this semester contained 6 instructors at 5 hospitals. I was assigned the #1 cardiac hospital in the state (also among the top 5% of all cardiac hospitals in the nation) AND my clinical instructor has 30+ years working in same hospital/teaching (she also happens to be the Med Surg II instructor).

Before I knew 'the teach' was my clinical instructor I was in love. She is a hoot! During lecture today she made statements like:

"If anyone would like to testify about their own disorders please feel free... BUT don't blame me when your friends look at you funny afterwards."

-AND-

"We all know that the Valsalva maneuver can result in a poor outcome in certain medical situations... isn't that right, Elvis?" [As she stood next to her life size cardboard cutout of the King of Rock & Roll in his gold jacket]

Smart. Funny. She isn't just a good instructor... she is a great instructor.

How good is my assignment? "You suck!" was the reply of my green-with-envy study partner.

[Chuckle]

My poor wife.

"I'm happy that you are happy now come in here and eat dinner and quit talking about it."

"Yes, dear."

Grad School May Be Closer Than Appears

2006-08-29T17:52:00.000-05:00

That is what should be written on my side view mirrors.

I spent the day hanging out with a fellow student nurse. She surprised me when she revealed that she had just submitted her application for grad school. Her plan to go straight into grad school REALLY peaks my interest.

Her plan is to work for the affiliated hospital and go part time to school. The hospital will pay for 12 hours per semester regardless if she goes FT or PT. She will end up having to pay for only one semester of tuition.

Me thinks I have a new plan!

CAKE!!!!!!!!!

2006-08-29T09:34:00.000-05:00

So the boys were enthusiastic about breakfast this morning.

Cake is the perfect breakfast food. It contains eggs, milk, & flour. Stands to reason one can serve it to one's children as breakfast (in a pinch). Right?!

Don't worry. They also had fruit, yogurt, and milk to drink.

This reminds me of an old Bill Cosby routine where he served his kids cake for breakfast... and suffered the wrath of his wife!

Meet the Fam

2006-08-28T20:20:00.000-05:00

T-minus 2 days, 11 hours

2006-08-28T19:45:00.000-05:00

That is how much time I have of freedom.

I've got to get rid of this sinus headache before school starts. Otherwise I won't be able to study effectively. I'm sure I've got a sinus infection. It has been a week solid of taking Advil Sinus to relieve the pain. The drainage is bright green so I know my ability to build a database of information and formulate a diagnosis is being honed!

The Fates Have Spoken
This past Friday started out with me loading my two boys into the car (officially known as 'Poppa's Car') to go to day care. Within a few miles, and along a busy highway, the car broke down.

Grandma saved the day. Kids finally in day care. Poppa's car towed to shop.

Friday afternoon and the phone call from the wife couldn't have been better timed.

"The brakes on the Ford have gone out and I'm stuck in Nashville."

Broken down Ford... $480
Broken down Toyota... $1,018
Two cars in the shop at the same time... PRICELESS!

Headache is overwhelming me now so I'm calling it a night.

Hopefully I will recover my sense of humor soon.

My Past Returneth... in a different shade

2006-08-23T23:58:00.000-05:00

My semester schedule arrived in the mail today. Med-Surg (part deux), Peds, Research, and Informatics.

Informatics? What the hey is Informatics?

"Its the use of information technology to guide and improve care," was her reply. My instructor went on to explain that it consists primarily of understanding databases and information systems for documentation & evaluating patient care. She seemed a little dismayed with my question. I probably deserved it since I should have checked this out ahead of time.

"Is there anyway I might be able to comp out of this class? I spent 7 years as a database administrator and understand how they work."

She was unimpressed. "This is nursing school," she replied. And I felt like an idiot for asking.

[Chuckle]

I'm not so foolish as to predict this will be an easy class (especially coming off such a difficult Summer) but I am concerned about how it will be taught. I hope this turns out better than expected.

Not to sound critical but I did leave the world of IT because it no longer stimulated me. Actually my interest in that world faded not long after I accepted the job. Three years into it I knew I had made a mistake but by that time I had accumulated a house payment and one child. So it took a blessing disguised in the form of downsizing that allowed me to switch gears.

Fast forward to today. I'm taking a class on information technology in nursing school.

Funny how things come full circle.

[Update: I have no fewer than 3 messages on my answering machine. My head is swelling from the requests from fellow students to help them with this class. I'm thinking I can offset some of this tuition by charging them through the wazoos! Just kidding.]

Not Too Fat for Couch

2006-08-22T16:42:00.000-05:00

ROS (Review of Systems)
Kids at day care. Check.
Pillow & blanket on couch. Check.
TiVo remote & cordless phone. Check.

First day post Summer semester and I have some MUST SEE TV to watch on the TiVo!

Have you ever noticed how medical disorders are discussed in terms of food? Med-Surg has ruined me on cottage cheese. I will never be able to eat big curd cottage cheese (a previous favorite of mine) again without seeing slides of vaginal Candidiasis in my mind!

Speaking of food... I have a thin crust, light-cheese, mushroom & onion pizza being delivered soon. I challenge my OB instructor to ruin pizza for me... no, wait. Don't take that challenge, please.

Yes. I am a complete couch potato today.

;-)

Bragging Rights
Successfully completed OB yesterday. What's funny is that a good friend of mine (who wants to specialize in OB) tied with me on the final and our semester grade (down to the second decimal place). We got the highest scores in the class!

The OB comp afterwards made me sweat bullets. That thing was HARD!!! One panic attack, two dizzy spells, several crying fits later, and I managed to pass ten points above national average. Wooo!

Our instructor congratulated us afterwards by revealing that this was the first time the program had all the men in the class pass the comp on the first try.

And if my day couldn't have gotten any better I discovered I had miscalculated my semester GPA. I'm still not happy with all my B's but I discovered that I had an A in one of my two hour classes. I received my semester paper in my student box with a 98 and the written comments, "You wrote one too many pages... you should consider publishing this paper."

Wow! I was speechless.

When I called my wife about all the good news she told me, "I'm happy for you but if you EVER do an accelerated Summer session again... I will kill you!"

[Chuckle]

It was a good ending to a difficult and challenging Summer. I never want to do it again!

The Joy of Friends

2006-08-19T21:39:00.000-05:00

Today, my wife and I spent time with two of our best friends. We've known them a long time. They graciously volunteered to help with our wedding, moved us into our first home, and offered much needed advice when we became parents.

Over the years we shared time at dinners, parties, poker games, etc. In difficult financial times they offered us free babysitting.

Our friends are old enough to be parents to my wife and me. Both of them are warm, sincere, and incredibly intelligent. They have raised 3 children. And they treat each other and everyone they meet with warmth & acceptance.

Anyone who has met them finds one aspect difficult to grasp... they are divorced from each other.

All to often in our culture we stand witness to the devastation people will inflict upon each other during a divorce. And sadly it is the children who suffer the greatest consequences. Divorce is equated to usinge children as pawns in the game of getting even.

In contrast, the entire time we've know our friends they have always shown respect and consideration towards each other & their kids. I have often remarked to my wife that if a couple has to divorce they should use our friends as examples of how to do it with the least amount of devastation.

The wonderful thing about today is...
My wife and I attended their wedding. We have learned SOOO much about friendship & love by witnessing their relationship all these years. Marriage is nothing without the foundation of friendship.

Congratulations C & M!
We love you guys more than you will ever realize.

Requesting Your Feedback

2006-08-19T09:37:00.000-05:00

It has been suggested to me by more than one faculty member that this fall I consider getting a PDA for clinicals.

So now I'm shopping around. This is right up my alley (so to speak) and I would LOVE to get a Phone/PDA but the data service fees are WAAAAAY out of my poor budget. So I am sticking with a plain old PDA.

If you are using a PDA and would like to make suggestions I would greatly appreciate it. I have about two weeks before I will need to get off the fence and buy one.

This is a request for advice on both hardware (PDA) and software (Drug Guide, Drug Interactions, Nursing Dx/Interventions, etc).

Too Fat, SN

Rolling On Floor Laughing

2006-08-18T22:56:00.000-05:00

Fun With Nursing Diagnoses

2006-08-17T22:01:00.000-05:00

Key for non-nursing friends: r/t = related to; AMB = as manifested by

Information Overload r/t summer nursing education AMB declining GPA & tension-type headaches

Alteration in Comfort r/t inappropriate nutrition intake AMB collection of fast food bags left in back of car, flatulence, & lingering feeling of high blood pressure headache (during finals week)

Alteration in Family Dynamic r/t collection of fast food bags left in car AMB threats made by wife to "clean up the d*mn car before I kill you," & statement by wife, "You are such a pig!"

Gender Based Vocation

2006-08-16T18:25:00.000-05:00

Today was a total waste of time at the women's clinic. The only good thing I got out of the clinical experience was a signed form to turn into the school stating I completed my hours.

Whooopie.

It would be accurate to say that the staff was uncomfortable with my presence as I repeatedly overheard the nurse's pitch:

"I hate to ask this but we have a student nurse today and he would like to observe... the student is a man."

[Chuckle] Like I just SHOWED up just to inconvenience them! I wonder why nobody said 'yes' after that? Don't get me wrong. I respect the decision of the client to say 'no'. The problem lies with the attitude of the nurse/physician. Ten clients and not a single opportunity all day.

At this pace nursing will continue to be thought of as a gender based vocation.

In contrast, a friend of mine who was at a second clinic today told me about his experience. The physician approached the clients positively and were able to get several to agree. My friend sat in and assisted in a variety of exams.

God Bless Bill Clinton!

2006-08-15T23:36:00.000-05:00

Love this article.

Bumped and Bruised but Breathing

2006-08-15T21:16:00.000-05:00

Survival & Sadness
Med Surg (part I) has ended and I am happy to report I survived. This has been by far the most challenging course I have ever taken (considering previous degree as well). It wasn't with the grade I was hoping (B) but I'll take it considering we have had to leave several students behind due to failing grades.

One student in particular has been a good friend and I will miss seeing her progress through the program with the rest of us.

I guess this is the bitterness that follows the sweet.

[Update 8/17/06: We lost one third of our class due to failing grades this summer. Man, am I bummed.]

Wait One Cotton Pickin' Minute Bucko!
Thats what I feel like someone said to me (not really) when it dawned on me that I STILL have one more OB clinical left. Yep. That's right. My celebration earlier (previous post) was a bit premature.

Tomorrow I report to a women's clinic to finish my LAST few required hours of OB. One of my fellow student nurses has made me apprehensive by telling me about his experience at said clinic a few weeks back.

"They don't like male nurses so I suggest you bring a book to fill your time. I pretty much just sat around reading all day."

Great. Nothing like a bunch of unprofessionals trying to act professional.

Thoughts on Nursing as a Profession
In my brief few semesters as a student nurse I have averaged one nurse at a clinical site per semester that has made her feelings known about men in the nursing profession.

It is really sad. Not for women. Not for men. But for nursing. It is no secret that nursing struggles to be viewed as a profession. And I am not suggesting that this is a unique problem with nursing (as other professions have had to "grow up" by accepting other genders, races, etc into their ranks).

Nursing should not be any different. Yes. Florence Nightingale did make the distinction that nursing should be considered a female profession BUT like all historical figures she was influenced by the era in which she lived. Medicine was considered a male profession during the same era... by the way.

Nursing should not be characterized as a female profession just as Medicine should not be thought of as a male profession. When nursing as a whole becomes more inclusive then nursing will be taken more seriously as a profession.

Preaching over. I have now stepped off my soap box.

Don't Mess with the Chicks!

2006-08-12T17:51:00.000-05:00

My first exposure to the Dixie Chicks was brief. I admit my first response was 'yeah... pretty women playing country/blue grass'.

But then I saw them on Austin City Limits not long after their first CD was released. That performance won me over. They are terrific musicians!

August Birthdays & Catching Up

2006-08-12T11:10:00.000-05:00

House of Leo (and one Gemini)
Our youngest turns 2 today. He'll get his prezzies later today. Happy Birthday, son!

My wife turned 29+7 on the 6th. She got an iPod... and guilt about my gift (read below).

I turned 29+7 on the 3rd. I got a T-shirt with Mr. Roger's saying, "Its good in the hood." (see.. told ya)

August keeps us busy. Guess I need to update my profile since I ain't 29+6 anymore.

Finals week
This coming week is going to suck. I have a final and a group presentation this Monday. My second final is Tuesday. The third final is Thursday and my comp is the following Monday.

Fun! (don't trust the smile)

During my hiatus from blogging I stood witness to my two A's melting away to B's. I should finish the semester with a 3.0 (four B's). Even though my instuctors tell me that I did extremely well for the accelerated 12 week summer session... I don' t believe them. It sucks!

My strategy for Fall is to regain the ground I lost over the summer. I can only hope.

Last OB Clinical
I was able to shadow a L & D nurse for a shift. Although the clinical started out a little bumpy it turned out to be a great experience.

The goal I hoped to accomplish for the day was to witness a vaginal birth. Keep in mind my two sons were both c-section babies so I had yet to witness a vag birth.

My instructor tried to accommodate my request and at first it looked like everything was going to work out fine but it didn't. As soon as my instructor left the room my nurse tensed up as she asked me:

"How do we approach this with you being a male needing to witness a vaginal birth?"

I have to admit I was irked by the notion of a problem. Especially since the resistance was coming from a nurse. If I was a medical student or a doctor my gender wouldn't have been a problem. The sarcasm center in my brain was tingling and I wanted to say, "Why don't you tell her that my sexual deviance arrest was expunged from my record days ago?" But I opted for the more direct approach:

"Why don't you just ask her?"

It turned out that my patient was a registered nurse so at least that fact made my nurse a little less tense having a male student in the room (my nurse probably notified security to stay on high alert).

Things changed rapidly after morning assessment. The expression on my nurse's face changed after the vaginal exam. It was during our brisk walk down the hall to collect the portable ultrasound machine when she shared her thoughts:

"I felt nothing but baby butt and we're going to have a c-section!" (Guess the reporting nurse is going to get a good thrashing when she returns to work.)

The ultrasound confirmed her assertion and we had to move FAST since 'mommy' had dilated an extra two centimeters in the 5 minutes it took us to retrieve the ultrasound machine.

It was exciting there for about an hour but we eventually got all parties notified (especially anesthesia... thank GOD!), got mommy's contractions slowed, and prepped for surgery. It was during the brief lull before surgery that my nurse shocked the hell out of me when she pulled me aside:

"This is an opportunity too good for you to miss. We have to get her to agree to let you feel that baby's butt."

Wow! I was surprised that my nurse would seem to make a 180 in attitude and I agreed. I did get to palpate my first son's head (vertex position) just before it was determined my wife needed a c-section. I hadn't ever palpated a breech presentation. Fortunately my pt saw the same educational opportunity my nurse did and allowed me to feel the breech presentation.

The surgery was uneventful, the baby was beautiful, and my nurse turned out to be a pretty cool mentor after everything was said and done.

I SURVIVED OB!!!
(now for PEDS this Fall)

One of Two Sides

2006-08-12T00:03:00.000-05:00

Recent news headlines are focusing on Bill Gates blasting the G8 countries for not contributing their share of funds in the global fight against HIV/AIDS. When I checked up on some of the articles I stumbled across this article that I thought I would share with you. I'm not trying to sway you either way on this issue.

My wife and I really struggled with the issue of circumcision before our first son was born. We knew that the heaviest influence on whether parents had their son circumcised or not circumcised was based on the status of the father. That wasn't good enough for us. We wanted more/better information before making a decision.

We ultimately based our decision (in part) on preliminary research that slightly tilted the scales in favor of circumcision. The information we found at that time focused on circumcision as a means to limit entry of HIV/STDs into the human host (by other mechanisms than the one defined in the above article).

The researcher mentioned in the article states:
"Other things being equal, in a circumcised population you have a low and slowly developing epidemic and in an uncircumcised population you have a high and fast developing epidemic."

In my opinion, we need to be objective and acknowledge the facts without injecting our emotions into the issue of circumcision.

Disclaimer: Before I get angry comments equating my support of circumcision with 'female circumcision' let me state my opinion on this entirely separate issue. Female circumcision is nothing more than a means to oppress women through violence. Female circumcision involves removing vital tissue (in various degrees) required for normal sexual function and should be outlawed wherever it is practiced. Circumcision of the male foreskin is not, I repeat, not the same thing so please do not leave me comments equating the two.

Nurse Note PRN

2006-08-02T16:40:00.000-05:00

I'm still breathing. No time!

EOSNS [translation: end of semester... nuff said]

Redd Foxx reincarnated

2006-07-23T09:21:00.000-05:00

My one year old walks like Fred Sanford did during his famous 'heart attacks'.

Quick Note

2006-07-23T08:33:00.000-05:00

The cute giggling that woke you this morning and got you in the mood to commence 'kissy-huggy' with your wife... wasn't the wife.

Your 4 year old's hands are now large enough to defeat the 'child-proof' door knob to you & your wife's bedroom!

Intervention:
Launch Sesame Street on living room TiVo (regardless if kids are awake yet) & LOCK DOOR!!!

Student Nursing Diagnosis & Another Night of Firsts

2006-07-22T13:48:00.000-05:00

I have to share. Going over my notes from a recent Med-Surg lecture I realized I mistakenly typed a wrong word and started an involuntary self giggle session.

My instructor mentioned the NANDA nursing diagnosis, "Risk for Infection" but I typed, "Risk for Information."

I found it funny because I thought it would make a great nursing diagnosis to be applied to the overloaded mental status of a typical nursing student. Okay. Its either a sad commentary on my state of mind or it really is funny. I'll let you decide. If you have some related to's feel free to leave them in the comment section. Who knows. Maybe we can collaborate on a new NANDA diagnosis.. HA!

No OB clinical this week (translation: one less care plan to turn in this week :-)

Med-Surg & a night of firsts
Disclaimer: For those of you with tons of experience you may roll your eyes in boredom so bear with me.

It is fair to say that I have spent too much time in class and not enough time in a clinical setting developing new skills. I know this is a weakness of mine and I only hope to get as much experience in the next few weeks, months, years that I can stand.

My strategy for this rotation has been to choose patients that have multiple diagnoses (especially diabetics). Its not that I'm sadistic... I just want to give injections, start IVs, etc.

Last night I had a diabetic patient BUT as it turns out he did not require insulin. Thats right. I pick the one insulin dependent diabetic patient whose blood sugar levels just so happened to be WNL (within normal limits). Fine! ;-)

Aside from the injection disappointment I did get to hang 1000 mL of procainamide. For those of you unaware procainamide is an antidysrhythmic that comes in a bottle... not a typical bag. Since a bottle is rigid it cannot collapse like a plastic bag as it empties its contents, hence... the release valve! Every so often the (student) nurse must open a little release valve found right above the drip chamber to allow air into the bottle thereby eliminating a potential vacuum. I know this is silly but hey... it was news to me.

Too Fat the IV pusher
The subtitle can easily be misconstrued but I'll let it stand... lol. I performed my first IV push last night. It also felt good to have the answer to my instructor's question ready to fire as soon as she asked:

"Now Mr. Student Nurse... how fast are you supposed to administer this drug?"

"2mL of famotidine mixed with 5 to 10mL of normal saline is to be infused over 2 minutes."

"Very good. Now quit standing around and get going."

I could see she had a knowing twinkle in her eye.

The Night of 'the Ugly'
In the world of (student) nursing there are clinical tasks that can be categorized, "The Good, the Bad, & the Ugly." Last night I had to perform what most would consider 'the Ugly'.

During report I was informed that a stool sample would need to be 'obtained' for lab (hemoccult) ... and the patient was not expected to have a bowel movement during the shift.

With a grin on her face & a giggle in her voice my instructor added, "If you haven't guessed this means you are going to have to go in after IT."

1630 student nurse accompanied by fellow male student nurse into pt's room to find pt laying in recently poured out pitcher contents (water)
1645 pt resting comfortably after gown and linens changed by student nurses & a fresh pitcher of ice water on side table
1646 pt responds to student nurse request for stool sample, "You go to hell!"
1700 instructor responds to student nurse report of pt refusal stating, "Give him a few hours to forget, try again, and bring a female student nurse with you."

A few hours later I was able to forgive my giggling instructor as her advice paid off. All my patient needed was a female hand to hold as Student Nurse Jellyfinger did his job.

One thing I remember from Foundations was that GI bleeds smell to high hell. Last night that belief was challenged... and I'm a believer!

I'm still here...

2006-07-20T17:19:00.000-05:00

Just leaving a note. I'm still here but my assignments and clinicals have heated up! Don't forget about me and thank all of you for such wonderful comments. They mean a lot to me. I hope to post again this weekend after my 18 hour Friday and 9 hour Saturday are complete.

Too Fat, S/N

The Week & More from Clinicals

2006-07-15T17:21:00.000-05:00

Monday started nicely. Can't complain about a 100 on anti-dysrhythmics exam in Pharmacology II. But it went down hill from there... fast!

Disappointment
Every once in a blue moon I fall off my horse (pony... whatever). I have a BIG bruise from falling on my pride... and the 72 (need a 75 to pass) I made on the recent Med-Surg cardiac exam. Believe me. No one is more disappointed. I dropped from an A average to a middle B. I studied for that exam all break (a week) and reviewed the information again starting Sunday for the test on Tuesday.

It is too easy to blame the instructor (as others have done) but I know the responsibility to learn the information lies with me. My goal was to knock the two cardiac tests (Pharm and Med-Surg 'out of the park'... oh well). I really wanted to demonstrate to my instructors that I am worthy of an advanced placement next semester. I sooooo want to work in a trauma unit, emergency room, critical care, intensive care... etc! I may have blown my chance.

I know what I did. For the first time in a loooong time... I panicked. I broke at least two rules I have for myself when preparing for a test. I studied a second set of notes (the instructor's... which I NEVER do) and I got only one hour of sleep the night before the test (due to losing confidence). Just stupid. I freaked out and suffered the consequence.

Moving on.

OB clinical... The Patient from H-E-double hockey sticks!
I know things sound negative this week but this is actually funny (now that I can look back on it).

Wednesday I worked post partum. I was assigned two patients. My first mommy was a day one post partum that delivered vaginally (this was her third) and... as it turned out... was an RN! (OMG!!!) But everything turned out well. She was easy and very pleasant. She was more interested in my program of study than being a difficult patient (which she was NOT by any stretch of the imagination). Very nice lady.

My second 'assignment' was a day two post partum that delivered C-section. Oh... if only my second mommy was as pleasant as my first. Its always a bad sign when your patient whines [Disclaimer: I was not the only one on the floor that commented about the whining... every nurse and even the physician commented on it]. Every hour... minute... second... spent whining. For those of you old enough... she was the real life version of the SNL character portrayed by Gilda Radnor, 'Wendy Whiner'. [Correction: Robin Duke portrayed 'Wendy Whiner'... not Gilda]

Anywho... my shift started at 0630. By 0631 I received notice from the nursing desk that mommy #2 (the C-section) was requesting my presence in her room. Fortunately my instructor went with me.

Upon entering, mommy #2 was standing in the middle of the room angrily shaking her IV pole and demanding, "I want this thing D/C'd (discontinued) now!" She wanted to go to the cafeteria with her boyfriend but didn't want to drag the IV with her (okay... I see). Before I could even open my mouth my instructor was handling it. After some back and forth it turns out that mommy #2 who had been on a liquid diet decided to eat an Italian 12" sub sandwich the night before without telling anyone [chuckle].

We discontinued her IV.

Here is an abbreviated version of the rest of the day with mommy #2:

0800 pt reported pain of 9 out of 10 in neck saying, "its like pleurisy," with student nurse replying, "pleurisy... in your neck?"
0805 student nurse notifies instructor that a telephone call to pt's physician is in order seeing that the only opiate PRN pain med on MAR is morphine IV [chuckle]
0830 student nurse reports to pt the situation with the pain med and a call has been placed to her physician; pt replies, "if y'all can't get my pain under control I'm going to the ER!"
0845 instructor marches to pt room and informs pt that she is not going to the ER and reminds her that if she hadn't insisted on her IV being taken out she would have gotten her pain med by now.
0900 telephone order from physician received by instructor; pt receives oral and IM pain meds... enough to knock out a horse!
0945 upon entering room pt found walking around room holding BIG camcorder filming baby in bassinet; pt surprised to see student nurse; pt reports pain is now a 10 out of 10!
1000 instructor rolls eyes as student nurse reports latest with mommy #2; instructor tells student nurse, "check on pt again in one hour."
1100 pt in high Fowler position nursing baby on right breast and watching television
1130 instructor returns with student nurse to room to conduct education session; instructor begins with topic, 'Proper Nipple Care for Nursing Mothers' with a swift reply from pt, "I don't breastfeed. I use formula"
1131 instructor undetered proceeds with new topic, 'How to Prevent Milk from Coming In'. [chuckle]
1200 instructor asks student nurse in hallway, "Wasn't she JUST nursing that baby an hour ago?"
1200:03 student nurse replied, "Yes. And her chart reads that way too."

I'll spare you the rest. But it was an interesting rest of the day. BTW, my instructor had a few choice words with the nurse who reported to me at the beginning of the shift for not mentioning the fact that mommy #2 was a freakin' psycho!

Med-Surg Clinical Week 4 - Contact Isolation
The patient I picked up on Thursday with a diagnosis of abdominal pain evolved into a diagnosis of E. coli 0157 by the time I arrived on Friday. When I asked my reporting nurse about a blood pressure/pulse oximeter for his room I was told:

"Just grab any of the ones from the hallway... that's what I've been doing all shift."

"Is there at least a cuff and a thermometer in his room?"

"No. I've just been using the ones in the hallway."

"Uhhhh. Okay."

It was amusing that the nurse manager felt the need to take ME aside to sternly grill me about proper use of gown and gloves. But, I think I won her over quickly. I told her I understood and brought to her attention that my patient, who is on contact isolation, has no equipment dedicated in his room for checking vitals. She thanked me and then proceeded to quiz my reporting nurse by asking, "What equipment have you been using to take this patient's vitals?"

Ouch! I stayed out of that one.

My poor pt turned out to be an easy case. He was a walkie-talkie that stayed in his room, watched tv and drank tons of soda!

Again... nice guy. I hated that he was going through all that.

Nursing School & the Challenges of Fatherhood

2006-07-08T14:51:00.000-05:00

Clinical Math
Our OB clinical schedule has been posted and I was surprised to learn I had one more clinical than expected. It turns out that clinical hours are being calculated differently than last semester (psych & community). The instructor is subtracting out lunch breaks. Last semester our clinicals were calculated by the total amount of time we were required to be at the facility. I'm not complaining b/c I need the clinical experience. I just wish my clinicals weren't stretching into finals week.

****************************
As usual, my head has been buried in the books. I'm studying for yet another round of tests next week. Every few hours I like to take a break and re-join my family for a taste of reality.

The 4-year-old & Clean Technique
My oldest receives the same instruction every evening before dinner from his mother, "I want you to go wash your hands before dinner."

Now, this is a simple request (you would think) but let me share with you how this simple request translates in the mind of a four year old and the resulting stages of hand washing:

Stage 1.) Declaration. The child makes the statement, "I don't want to wash my hands." This is not effective but it is an honest sentiment and it is considered, in combat rules, a 'warning shot over the enemy's bow'! This stage sets the tone for the coming sea battle.

Stage 2.) Relativity (aka 'My Parents are Fools'). Identifying this stage is easy. One just listens for the 3-5 seconds (max.) of water running in the bathroom followed with a proclamation, "Momma? I'm done!"

Important parent note: Discretely look to see if the soap tray is wet or dry

Stage 3.) Realism. This stage is the result of introspection on the part of the child. The child realizes that all attempts up to now have failed. If he/she is going to have a chance in hell of getting out of actually washing hands... now is the time to get serious about deception. REALISM IS A MUST: 1) turn water on for a miniumum of 30 seconds, 2) sprinkle water on soap dish, and 3) a better, fool-proof proclamation to 'sell' the idea of cleanliness is required, "I used soap this time!"

Important parent note: Check BOTH hands & hand towel for traces of moisture.

Stage 4.) Surveillance. This last stage is not always necessary but it is easily identified by a direct order from Admiral Momma to First Mate Poppa, "Get off the couch and go watch your son wash his hands before I hurt you!"

Note: a child does not have to go through all stages in sequence (with exception to the first stage). Stage 1 is required because it is good combat etiquette. The MOST important thing to remember is that Poppa gets off the couch and does exactly what he is told!

Happy 4th of July, USA!

2006-07-04T23:02:00.000-05:00

Just got back from the fireworks display at the university. It turned out to be slightly more pleasant than expected. We timed our arrival perfectly. With two kids in tow (both under the age of 5) we were seated in the grass 10 minutes before the firework display started.

I was expecting it to be hot, humid, and somewhat uncomfortable. But it turned out that a storm was rolling in from the South and with it... lots of breeze. We had fireworks to the left of the symphony stage and a lightning storm (off in the distance) to the right of the stage. It was kind of weird not knowing if the BANG was from the fireworks or the storm!

Fortunately, we never got any rain.

So that does it for the official vacation (vacation=no books, studying, school stuff). Tomorrow the wife goes back to work, the kids go to day care, and I go to the library and start hacking away at my list of things to catch up on with school.

Happy 4th!

Tell Me Again Why Nurses Can't Wear Capes?!

2006-07-03T23:22:00.000-05:00

Today was the first time in months that the wife and I have had time off at the same time... AND DAYCARE! Actually we've known since last Thursday when my wife's boss told her to go ahead and take Monday off.

So, since Thursday I've known how I wanted to spend our time together once our getting-reacquainted-time was addressed. I wanted to see the new Superman movie, Superman Returns. But I was afraid to mention it to her in fear that she would immediately shoot it down.

You see my wife knows she married a big nerd. Computers, gaming, comic books... I've done it all. The computer career is over (obviously), the gaming hobby is long dead, and the comic book collecting ended 2 decades ago. So it didn't come as too big a surprise when she finished my sentence for me.

"Sweetie, I have a request about this afternoon. I was hoping we could..."

"Go see the new Superman movie," she blurted. "I knew you were going to say that."

I could see that she was somewhat less than enthused. In recognition of that fact I did offer to back out and do something more wife friendly. But to her credit she would not deny me this little pleasure and so... off we went.

This review comes from someone who sat through the original Christopher Reeves series (except Superman IV... nobody should have to suffer that one). From beginning to end, I thoroughly enjoyed the film. And as much as this is high blasphemy considering the late-great Mr. Reeves... I enjoyed Superman Returns more than the original series. The story was well written and there was just the right amount of tension between Superman & Lex Luther and Superman & Lois Lane. I highly recommend it.

It was on our way back from the movie that my wife threw me for a loop.

"It surprised me that it was a romantic story."

"So you liked it?"

"Yeah. I can't believe I'm saying this but I did. I liked it."

I love my wife.

Eating In The Bathroom

2006-07-02T23:28:00.000-05:00

I have to admit that before I became a father I never paid attention to the discrimination women suffer when it comes to the subject of breastfeeding.

My wife would get the occasional glare whenever she needed to breastfeed in public but that was easily handled by her angry gorilla-of-a-husband flipping off said glarer (besides, it was fun).

I even had an acquaintance (who shall remain nameless) admit that he had a problem with women breastfeeding in public and they should go to the bathroom to keep people like him from feeling uncomfortable. Let's just say this guy didn't get much action in the girlfriend department and had other more pressing issues (namely finding a brain).

But this acquaintance did state a predominant sentiment that I witnessed in the corporate world. My boss from three years ago chose to breastfeed which meant she had to find time throughout her day to go to the only room the company would make available to her to pump... which was the bathroom. I can remember her uttering under her breath several times, "I wonder how many Bridgestone/Firestone executives eat their lunches in the bathroom?"

Madonna/Whore Complex
That's right. It all relates back to our twisted thinking about women that has led us to taking issue with a normal bodily function such as breast feeding and turning it into a perverted act. We want women to be whores in the bedroom but hide away (their breasts) and be virginal otherwise. Despite the fact that our society markets cleavage to sell everything from orange juice to satellite dishes.

There is one undisputed fact...
BREASTS ARE FOR NURSING BABIES!

And since babies make up part of our society... they need to eat... and yes, sometimes that is in public!

So this is directed to you guys out there who think women should go to the bathroom to "whip out a boob to feed their kid":

Get over it!
If you tried to get over it and can't then you need to get some counseling (unresolved Oedipal complex maybe?)
If the first two suggestions don't help then maybe you should start eating your meals in public bathrooms

If all this doesn't work for you then maybe you should just admit that you're a shmuck and need to get sterilized so you don't cause more problems by breeding. Enlightenment is not your thing.

Week In Review

2006-07-01T22:59:00.000-05:00

OB clinical this past Wednesday was interesting. I was assigned two patients in the nursery. A boy and a girl. Cute kids. I REALLY relied on the skills I've earned as "Poppa" to my two boys. The little boy was borderline jaundice so we had to keep a closer eye on him. The baby girl was as fat and cute as could be... but fussy! They both were good eaters although the baby girl would not go to sleep for anyone else in the nursery but me.

Overall, I didn't really see anything I hadn't seen before until the offer came to witness a C-section. I jumped at the chance. It was quick but interesting. There were no surprises... I recognized every part that was being manipulated (which is good since I've invested umpteen zillion dollars in A&P classes). The OB performing the procedure was very gracious. The scrub nurse was equally gracious. The patient had elected to have tubal ligation performed. That too was interesting to watch.

**********************
Med-Surg clinical, this past Friday, was fairly uneventful. I picked up my patient assignment Thursday afternoon for the following day. Friday clinical started and I had all my paperwork ready that included a care plan and 15 new drug cards (important to mention that I stayed up the night before working on it). And then I arrived to find out my patient had been discharged earlier in the day. Happy for the patient but it sucked for me.

So I got my NEW patient assignment minutes before having to start her assessment. Just rolling with the punches!

But, I shouldn't complain. She was a sweet lady. Poor thing had a stage 3 decubitus ulcer on the lateral aspect of her LLE (translation: crater on the outside of her left foot). I liked her especially because she asked me to turn the thermostat down as low as it would go! She won major points with me on that request.

Despite her wound she turned out to be a walkie-talkie so I didn't get to do too much for her.

During post conference my instructor informed us that she was giving us a few extra days to tweak our care plans (since we hadn't received feedback from our first care plans until just then). It was a nice gesture. Would have loved to known that for reasons I stated earlier. But that's life.

**********************
Halleujah!!! I have all of next week off. Our dean scheduled the coming week as a break to give (as one instructor stated) "time for the students to blow off steam... and the instructors NOT to kill the students!"

UPDATE!

2006-06-30T07:31:00.000-05:00

Again, sorry for not having the time to post more so I thought I would add this little update.

I posted earlier that I was disappointed in a Med-Surg grade where I made an 80. At that time I was the only one in the class to have passed (OMG, thats bad). Well it turns out after our test review that the teach mis-keyed the grading machine which resulted in several answers being marked wrong when they were actually right.

Type I-III reactions are humoral immunity responses... type IV reactions are cell-mediated immunity responses. That little tidbit of knowledge bumped me up 9 more points (80 to 89)! Hellooooo B territory.

There were several more people that actually passed the test (besides me) after all.

Little note for professors. It is ALWAYS worthwhile to review tests with your students. We aren't the only ones to make mistakes.

;-)

Obviously obvious

2006-06-26T22:40:00.000-05:00

I don't recommend reading your own postings.

I didn't just over use the word "obvious(ly)" in that last entry... I crucified it!

"Paging Doctor Stereotype!"

2006-06-25T10:01:00.000-05:00

Too busy to really write anything but I thought I would add this...

During morning coffee and entertaining the kiddies I found myself thumbing through one of the billion scrub catalogs I find myself receiving these days. They're all the same. Twenty pages dedicated to women and the last 2 pages have scrubs for men (token).

This one particular catalog has about ten illustrations of men modeling scrubs and they are all using one of two male models (a white model & a black model). I couldn't help but notice that there was only one picture with an obvious RN emblazoned on the breast pocket... and it was the black guy. There were no other pictures of obvious male RNs... especially not one of a white guy!

As a matter of fact all the pictures of the white male model had D.D.S. or M.D. stitched on his shirt.

[Insert forced, sarcastic laughter for an obvious reinforcement of stereotype here.]

On the flip side...
I have had two med-surg clinicals & both times I was addressed as "doctor" at least once during each shift. Once by a patient... and once by an RN?!