So far, this has been an interesting integration. It can be hit or miss depending on the preceptor you get, and the clinical site you end up at. I was lucky and got my first choice place, the CCU at Millstein. I don't envy the folks doing the "other" specialties (Family, Adult, Midwifery, etc) because from what it sounds like, the folks I've heard from are not loving integration.
One person said they were basically teaching him to be a unit clerk and wanted him to answer the phone and such. Wilson is so awesome he just looked at them and told them no.
My story about my preceptor and the Tai Chi (and my not being able to say no) will make the horror story mandatory town hall meeting next year, Sunni said as she laughed a relieved sigh. "I thought we were going to have to find another placement for you" she said.
I think, getting back to my subject, that my friends in Adult are finding that their placements are the same horrible placements we had throughout the year--there are still nurses fighting on the floors, and disdain and loathing for Columbia students, etc.
I lucked out. The floor I'm on is almost exclusively run by Philipinas. Of course, coming from Daly City, they all love me. Not only have I mentioned Joilibee (which I come to realize is significant because it's the first chain in the US of a Philipino based fast food chain) but I also jokingly refer to them as "Ninang" (godmother.)
I heard grumblings from one nurse of Jewish decent. She was giving report to the other preceptor and student coming on night shift. She said "I miss working nights" to which all the night staff scoffed and looked at her funny. She said "oh no, it's not the nights I miss, it's that...you guys are all my age, and...not philipino..." and the other nurses went "oh...yeah"
I guess it can be a bit cliquey with the day staff. I am the only anglo there. But, I feel right at home. And they're very nice to me. So no complaints. I think K (the other student) really likes her preceptor (which is good) and being on nights and would rather that than have to deal with my day staff.
So, that's all there is to tell today. I've got case management class later tonight, so I'd better get hopping. I've got a case study to finish up, and about 8 clinical logs I have to do to hand in. It's a load of writing writing writing.
It's working out great, however, because I'm actually learning something this semester. I'm running up against stuff I dont' know, and doing the research and finding out on my own...this is self-learning mode, I guess. The folks that just show up to their integration site and expect to be spoon fed or told what to do are the disappointed ones. I was lucky I went in and already knew something from the ACLS stuff that I had done on my own over the break...so that made them want to teach me more as they found me worthy of it. I think a lot of students are getting treated like diaper changers still.
OK, back to the writing. I'll try not to be so boring next time :D Miss you all!
Legos Monty Python stop-motion film and the movie "the Holy Grail" which I've seen probably 2 or 3 thousand times. put them together and you can't go wrong! now, if I only had a pizza...
So, I guess she teaches Tai Chi on Wednesdays, during her lunch hour. So, on wednesday, she decided that rather than do what I usually do on my lunch hour (get off my feet, rest and have lunch) I should go to Tai Chi with her.
Being one who can't stand up for myself and say No, I went.
Of course, she makes me take off my shoes, which I shouldn't have done. I have this problem in my achilles tendons...I can't walk barefoot or in flat shoes for very long without my ankles swelling up and lots of pain.
But, I didn't say no.
Tai Chi is not my thing. It's not like Yoga (where you listen to your body and follow what you can do) Apparently, Tai Chi is about hurting yourself.
I was instructed on a few basic moves, which when I attempted them, made her very nearly sick. "no no no, not like that, like this"
Try and try as I might, I couldn't get her to understand that my body will simply not bend that way.
One thing that was painfully clear: for a nurse, she has no clue that the knee does not, nor should not, move laterally. She continually came over, braced her knee against mine, and pulled on my upper back towards her, and a few times I nearly fell on top of her.
After asking her twice to not pull my back, and having explained about 20 times in 2 days that two weeks ago I had thrown my back out and it nearly cost me the year, she finally tried to force my body into a position that really sent a jolt thru me.
I was done.
I sat on the floor of the basketball court, and finally laid down, and brought my knees up to my chest. I think she finally understood that when I said "I threw my back out" I didn't mean that I had a little achey back for a few hours.
Limping back to the hospital, she said "why don't you just take lunch and then call it a day...it's not like there's anything going on anyway"
I wouldn't have taken her up on it if I hadn't really, really needed to lay down.
The following morning, I got an email from my liason, pissed as hell because she had gone to my clinical site and I wasn't there. She said something about my vacation being over, and blah blah.
I replied that I didnt' think cutting it three hours short was a vacation; explained to her what my preceptor had done to my back during my "lunch" hour and considering how bad my back was hurt last semester, I didn't think three hours was going to make or break, especially when my hours are scheduled to be done by May 1st.
So, I go back tomorrow. Today, I can just sorta hobble around...mostly it's my right ankle (the one I tore the ligament on 20 years ago) that is hurting the most. How I'm going to get around for 12 hours a day, both weekend days, is beyond me.
Thank god my preceptor is away for a week or so. I hope this new preceptor is understanding when I tell her I can't do certian things. What pisses me off is that I was FINE until her Tai Chi class...I learned a valuable lesson. My health is more important than what people think of me...I'm saying NO first from now on. In fact, I'm thinking of starting all my sentences with it from now on.
and ending this post with it. Do I think Columbia's nursing program is worth the money? NO.
The Cardiac Care ICU is very different than the med surg floors or the step downs. I've noticed that once a patient is well enough to complain about their room not having any windows, or something like this, it's almost time for them to be leaving the ICU. If you're well enough to notice or care, you're usually almost ready for the regular step down unit.
There are several patients that are heart transplant recipients, and others that are there for cath lab, so they are in varying LOC from completely obtunded to A/O x3.
Today, my preceptor ran a tape on my patient and said "here, tell me what you see" but walked away. When she came back, I had been staring at the tape for a good 5 minutes and fought back the urge to say "a black squiggly line." I was glad that I'd postponed taking the ACLS test and took my books home with me during the break. Somewhere over the purple mountain's majesty and the amber waves of grain (ie, on the plane ride home or back) I re-learned all the parts of the ECG, what each part means, what's going on at each segment of the wave, and variations of a few. I remembered that an elevated ST segment means ischemia. And I was glad she didn't ask me yesterday when this patient had a depressed ST segment in lead 2 and all I knew was this indicates "injury."
I quickly flashed to the show "Scrubs" when during rounds Elliot always smugly gives her dx. So I tried to contain myself and threw in some doubt.
"I see an elevated ST segment and...possibly a missing R wave?" "no, there's an R wave, but it's just very, very small. What's that mean" "ischemia?"
:D
So, if my preceptor hates me it's not for being stupid. It's for other reasons, hah.
She taught me a few things about the ECG that I didn't know, and I was excitedly trying to write it down. SHe said "it's in your books" but I'm pretty sure it is not.
Anyway, it's pretty cool. The 12 hour shifts seem to fly by--by that I mean, even with one or two patients, one is hopping around and still needing more hands, more hours in the day to do everything one needs to do.
I bought my ticket home tonight. A one way. Free at last! May 15th, I turn the page, end the chapter and the book that started May 31st of last year.
Ay caramba. It's only been a year, but this program has sucked at least 6 or so years of life out of me...it's like trying to wet your lips with a fire hose. But I talked to one former ETP student there, who also quit after the first year. Does ANYONE go on to finish that masters?
I walked into the med room and two nurses were talking: "Because Columbia's nursing school SUCKS!" Neither of them took notice of me in my Columbia School of Nursing uniform...I turned to her and smiled and nodded, and she said "I'm in the master's program now, it's so disorganized, it's a mess!"
and all I could do was nod, and smile and say "the undergrad portion isn't so hot, either"
Well, for a start, I'm home in beautiful San Fran. The weather was beautiful today (went out with a sweater and no coat) and I met up with an old friend from the City College days (Lovely Irish Cathy, herself about to graduate this year from USF)
I've nothing much to say other than I'm just tired as hell, glad to be home, and looking forward to finishing this program. My favorite preceptor, John has taken my suggestion and started a blog (YAY!) and I'm looking forward to reading some actual nursing stories, from his adventures in Africa with Medicins Sans Frontiers.
I've yet to submit my evaluation for my preceptors this last rotation; they sorta pulled the rug out from under me and I'm still a bit singed about it...so I'll wait until I can think of a way to say what I want to say without it sounding like I'm whining about their (obvious) confusion about me as a student. More and more I regret having signed it. Oh well. All I could think was that I was done with that semester.
I arrived yesterday afternoon, feeling broken and extremely tired. I can't believe I'm almost done with that whole mess and I'll never step foot anywhere east of Colorado ever again.
The weather is so amazing. It had to be in the 70s today. We went out for Zaos and a beer and sat outside and got some sunshine...all around San Fran, people dressed like it was summer, sandals, shorts, miniskirts, tank tops...to think of my poor friends back in NY bracing against that misserable, dessicating wind that sucks the life out of you.
I swear I look 10 years older, (but feel 20 years older) than when I left.
I haven't filled out one eval yet, on my last preceptor. I've got something about her evaluation of me that I want to address, but I'm trying to find a tactful way to phrase it.
I called my preceptor for integration, she sounds really nice. She's unfortunately only going to be there for a couple days and then goes on vacation for several weeks...so I have to find a new preceptor while she's gone (great.)
Anyway, for now, New York is a million miles away, and I'm home.
I guess the saying is true, the only way you can come home, is to leave. I certainly appreciate the bay area much, much more since I left.
Spirit of the staircase. The little ghost that hangs out waiting for you to be passing by, on the stairs, and it whispers to you the appropriate come-back for what you just stared blankly at.
This has happend to me today. well, in my defense, I'm distracted.
My preceptors gave me a couple "acceptables" which is pretty shitty, to me. Considering all my other evaluations were so good. Last rotation, psych, I got all 4s (Exceptionals) and they've warned the preceptors not to do this, because "no one is exceptional."
So, my preceptor, whom I've seen 8 times, said something about me always seeming to wander around, looking for someting to do, rather than "hang out in the room with my kids"
LOL yeah, when there are two blood pressure machines on the floor, and you can't find one, you tend to wander around, looking for them.
They also made 2 comments about weaknesses and asked me to come up with a third. While most of the ass-kissers said "gee...I really need to build confidence calculating meds" and bullshit like this, I responded to one of their critiques about me.
They said I "tend to get frustrated" and that I "need to remember that they're only KIDS!!" to which, I said, that I took this personally, because the patient they were referring to was this little ten year old bitch who was so absolutely shitty to me, that she struggled and fought me the whole time. "I only need to get your temp and blood pressure," I said, and she would fight and kick and say "NO!!!" and pull the covers over her head, and so on. I said, it's hard not to take this personally, when the patient was in such a bad mood that day. Sure, I admitted to being frustrated, that day.
She wrote, for my third comment "takes things personally"
ROFL A former architect, someone who goes through school hearing that your work is shit, and to do this over; who has long ago separated comments about my work, and myself...takes things personally. Whatever.
In the end, my passive-agressive group gave them two $35 gift certificates, ($70) and said this chip in was $14 a piece.
There are 8 of us.
You do the math. This adds up to $112. Aren't groups fabulous? Perhaps the remaining $42 went for the 2 dozen cupcakes someone made the night before.
Or...Three people didn't chip in. But, today was my last day with this group of people, and I can say I'll miss one or two of them, but beyond this, I'm glad to be done with all the passive-agressive/adolescent games.
Now, I hear from someone in the "real world" that she's going thru this now! Oh no...you mean it doesn't stop!? Say it ain't so! (female dominated professions, great)
I have my PEDS final tomorrow and then I'm done.
I have a slew of dr. appointments when I get back: I have a palpable sublingual nodular mass, and it's scary. Probably caught something fatal in this shit hole.
I can not WAIT to leave New York. I seriously can NOT.
Coming from San Francisco, a major metropolitan city, I thought NY would be no different...great food, everything is open 24 hours...right? Just like San Fran on the east coast? Wrong!!! New York is a disgusting city, dirty, smelly, and the people...don't get me started. This program is a disaster (putting it mildly) and it's only getting worse. No one knows, or is willing to tell you, shit. You fly by the seat of your own pants. There were 168 of us that started, there are 157 of us now. Many folks are just hanging in there for the passing C. (want those nurses?)
I've managed to keep nearly a 3.5, which is absolute crap for me (compared to my undergrad in architecture and my prereq courses...OK, I got a B in Physics, and I think I got a B in Advanced medical chemistry, but beyond that...)But this has pretty much been at the expense of my health and life. I study ALL DAY, and there's still not enough time to read everything you need to read in order to make a passing grade. The tests are impossibly hard (but they tell you it's in order to get you ready for the NCLEX) well...how about instead, you learn the subject you're teaching, and know the corresponding names of the anatomy, hm?
I'm meeting with a well-connected someone over the break to see if they can help me make the transfer to a California school. If I have to come back here, I'd rather jump in front of a New York Subway (and die among the rats.)
Ugh! This place blows so much... Now I only hope my integration preceptor isn't some freak with issues, and I can actually learn something in the next two months. I'm so outta here, then, that it isn't even funny.
Holy Cow, everything has log jammed from last week onto this week. I have to take the midterm (I missed last Friday) tomorrow after clinicals, and after that I will be back on track. My Final is Friday.
People are coming down with stuff, putting out their backs, and in general falling apart. I don't feel so bad now, I was really feeling guilty about hurting my back. (I'm better, btw)
A friend took out her neck and upper back and was referred by me to the student health services, where she got the same anti-inflamatories and muscle relaxants. She said she took one of the muscle relaxants and got all loopy (glad I didn't take those! I'm already loopy, imagine how much more loopy I could have gotten)
I'm sorry I haven't been able to return calls/etc, but I've been seriously busy trying to catch up what I missed last week, and getting ready for all the exams/assignments due this week. So far, I managed to do it, and tomorrow afternoon I'll be free to start cramming the final.
Yesterday was hilarious: a mandatory town hall meeting that was supposed to prepare us for integration. The overall, take-home message was "do NOT come crying to US!"
We got to hear several examples of where students failed to be proactive and screwed themselves over. What I heard is that we get even LESS structure and support and have to do even MORE way finding than we're doing now.
They're logic: "If you can make it through this, you can make it through anything."
ah...thanks, Columbia.
Story after story about being not able to contact preceptors, about preceptors going out on sick-leave and students calling the office saying "what do I do now?" and the basic come back was "go talk to the nurse manager and find out if there's anyone you can work with" but basically--go find yourself another preceptor.
Another great story was where one preceptor got into a screaming, shouting match on the floor because another nurse was pissed-off that she had x patients and the preceptor had a lighter load (x minus student, presumably, if I had to write the formula) and the student was caught in the middle of it.
"if this happens to you, you have to get in and say 'guys? I know there are a lot of strong emotions...but we can find a solution to all this' you have to fend for yourselves" and at this point, all of us having felt the way we've been made to feel by some of the nurses on our floor, we all burst into laughter.
Is she kidding? While there is a heirarchy here, the 100% scorers, and smarty-know it alls, and the other end of the spectrum, on the floors, we're all big blue idiots. (reference to our uniforms)
We just try to do what we can, we do all the dirty disgusting jobs while smiling, and nurses dont' have to do anything but dispense meds, and yet we are so reviled.
The very thought of interjecting between two vicious, fighting, scray-ass nurses, was preposterous. We'd be handed our heads. What does she think we are? They hate and us! We're all cramming this in a fast amount of time and they know it, and they hate that, even if at the end of it we've learned quite a lot.
We've all seen plenty of them that don't seem to know much, (one student caught a medication error that would have been REALLY, REALLY bad) or maybe it's that they don't remember much, or maybe they did one of those 2 year junior college programs while working as a CNA and to them, THAT'S the way dues are paid. Or maybe it's that this school costs nearly a hundred grand for the one year. (whatever it is...60-70 grand tuition, plus cost of living...round it up to a hundred grand of debt)
"guys? we can find a solution" BWAH HA HA HA HA HA!
that was a good lecture...worth the price of admission. So I guess we get our liason and preceptor's phone numbers, Friday, and we're to begin trying to contact them IMMEDIATELY because I guess, it's next to impossible.
They made it sound like last year, people couldn't get through, no one knew what the student was talking about, even a few preceptors didn't know they were preceptoring because they had forgotten that they had said they wanted to in the beginning of the year and then when they were presented with "you're my preceptor" they said "oh. I am?"
Great job of communication, Columbia. In lumine tuo, videbimus lumen.
I can see now that this back thing is going to be vexing me for a while. It's not a common cold that progressively gets better. There are going to be good days and bad days. Yesterday, I thought I was outta the woods, but today I woke up a little "twingey" in the back. I'll have to not be sitting up all day, and take some lie-down rest breaks.
I thought I had listened to 40 or 45 minutes of the childhood immunizations lecture, but when I looked at elapsed recording, it was only 13 minutes. This guest lecturer has the most painful accent to listen to, combined with a quasi British drone of monotone, that makes it impossible to get what she's saying. And, I'm dictating my notes into Dragon Naturally Speaking software, which does the voice recognition, and typing for me. She's so all over the place and so fast, and she speaks in endless run on sentences, that I have to back the recording up and listen to the same piece half a dozen times to get a small sentence written.
So, While I might have been transcribing notes for over an hour, I only effectively listened to 13 minutes of lecture :( At this rate, I'll be done with her lecture some time next February.
Plan for today: rest the back (horizontally) Listen to Dr. John's sleeping pill lecture about vaccines, get as many notes as I can in as short a time as possible, and try to rest up for the coming (FINAL!) week of classes.
Here's why: I woke up on my own...not from the stabbing, knife-like pain in my inferiorly designed lumbothoracic region, but because my alarm went off.
No pain!!!!!
Can this be? Surely when I move, the pain will be back. So I reached to shut the alarm off and, nope...no pain.
Oh Frabjous day!
Then I called the ACLS place and talked to someone with one of the thickest New Yawk accents I've ever heard (Lwang Island) and explained to hm that I had called Thursday, but that I was waiting to see how I felt and neglected to call yesterday. "No Prwoblem, cwall tha office Mwonday and tell tham ya need ta reschejool."
What? even though I'm not coming in today? no 24 hour notice or I lose my fee? Nope....
Oh, Frabjous day! I had been up until 1:30 RE-learning (what is this, like the 5th time now?) my ECG stuff. Elevated ST segment means myocardial injury, depressed ST segment means ischemia...labeling the most horrific looking waves (seriously...are these folks alive?) when they have inverted T waves, no S waves, or a notched R...holy moly.
So, THIS means, I can continue my cramming and transcribing of Peds notes, and work on taking the test, and have my stupid ACLS thing done in April, by the time I come home to work in an ICU.
I'm just glad to be rid of the back pain. I think I was just stupid and felt better thursday, so I didn't take the Naprosyn, and Friday I was feeling it again.
So, I'll take the damned pill again this weekend, just to keep inflamation down. Now I'm thinking of the line from the Eagle's song: "Take it easy"
WHEW Finally! A Frabjous day. I have been waiting for one of these! :D
I woke up today with every intention of going to class.
I set my alarm early, got up, made coffee, and then somewhere between getting dressed and leaving, I felt a sharp pain again and said...Yikes...I'm not ready yet.
Flipping Buddha! I missed an entire week of classes. How sucky is this? The only thing I have going for me is that Thursday I started the cram; perparation for finals week (this week coming up) and cranked out all of the projects that were due this last week.
Now, I've got to take this test I missed today some time next week, my final is friday, so the earlier the better. I have another project for Evidence based practice, and another quiz/assignment for Issues of nursing practice, then Monday we have to go to a mandatory town hall meeting to discuss our integration and Tuesday is the practice NCLEX exam. After that, I've got one more clinical day (well, really half, because the other half is just presentation of my case study) and the following day is evaluations and we'll be outta there by noon or so.
Saturday I'm flying home.
Holy crap, I just realized I forgot to cancel my ACLS course this weekend. I'm sure it's too late to cancel tomorrow...So now I've probably got to go, damnit.
My new favorite song...seriously...it's like crack
It's just like it's just like a mini Mawl...
But that isn't where it ends, oh no Flea market flea market montgom'ry hey hey it's just like it's just like a mini MAWL...
Living rooms bed rooms dinettes OH YEAH you can find em at the market don't stop let's make it a dance To the left! (to the left!) To the right! (to the right)
Help meeeee Jesuuuuussss! I can't stop watching it!!!!
it was so much pain, all I could do was lay on the floor of my dorm room and cry. Couldn't move for hours. I dry swallowed some aleve and ended up emailing all my profs (as soon as I could get to the laptop, and since I couldn't sit, I had to connect to the outlet near my bed and type in my lap rather than my desk)
What a nightmare this week has been. I finally got some 500 mg Naprosyn from the student health services (high dose Aleve) and that did the trick. I didn't want to take the muscle relaxant (flexeril) because I read up on it in my pda and didn't like the sounds of it.
I'm so glad I came home Thursday and Friday and cranked out two case studies, and an assignment for Evidence Based Practice class, and did my part of the written report for Issues in Nursing class. That was my lifesaver. I was able to say "hey prof, I'm dying, but here's my work in an email attachment" and that saved me.
I guess they could see I wasn't faking it to get an extension.
However, tomorrow is my Peds midterm, and today is the first day I've not had so much pain I could not comprehend anything I was reading. I received a post card junk mail offer from the grocery delivery service I use...I swear I must have picked it up and read it 8 times and could NOT understand what it was saying. Something about free delivery...but I couldn't understand the terms (turns out they were offering a free unlimited delivery service if you paid fifty bucks for six months)
So, here I am, still sorta on my back, resting up for tomorrow. I'm just glad to be out of the level 10 pain. Mental note...bring home a foley kit, in case this ever happens again!
