I'll see you in the ICU!

No Sleep 'til Brooklyn...again!

2009-09-08T05:11:00.000-07:00

Not sure if it's the time difference, or the fact that I had a list of "to do" things for today that kept running through my mind in that same pesky way a bag of marbles, dropped on the floor runs in every direction--I'm that tired...I've no idea what that sentence just said.

Basically, I fell asleep at around 3 am, and got up around 6, when my light timer was (evidently) set to go off. Either I did this to ensure I wouldn't miss my flight back in July, or, I have it all screwey since I unplugged it over the summer break. In any case, I slept another 3 hours last night.

Add that to the 3 I slept the night before, and you get 6! Almost enough for one night (sigh)

I'm off to my first class today--Pharmacology of Anesthetics. I'm nervous, anxious, and have a great need for sleep.

My best friend, Jean, is also in town and I want to see her since I didn't get to see her when I was home on break.

The good thing is that I don't have class again until Monday--but the bad thing is there are a million things to do and already tons to read and study before then.

I asked for it :)

Done and DONE!!!

2009-07-29T09:34:00.000-07:00

Advanced Clinical Pharmacology Notes.
Somehow, I survived!

So it's the end of semester one.
I'm usually so amped up, and busy, that when the end comes I never know what to do with myself. So now, I've been washing the floors, doing laundry, washing the refridgerator, spring cleaning in general.

I leave for home Saturday--my driver, Jose picks me up at 6:30 am, and hopefully, there won't be a thunderstorm (though, it would be a first when I'm flying) and we won't get delayed and stuck on the tarmac for hours and hours (like last time!)

I'm so looking forward to going home and seeing my fellas :)
I've missed them so.

But I go home with a sense of relief and accomplishment; I was afraid about the chemo having ruined my chances to study, to learn to retain info, to go to school in general--I'm releived to know that I CAN do this. I can.

Not that it won't be tough, but it's not like I have mashed potatoes for brains, as I feared would happen after the chemo.

It's a balmy overcast day in New York. I don't mind it so much this time around--I guess cancer taught me to suffer through things that are temporary with a bit of patience.

Sunday morning I wake up at home, and all this will be like a dream.

Heading into Finals...

2009-07-22T09:29:00.001-07:00

Finals week
How I study for pharmacology.
Each lecture is 4 hours long, each test covers two lectures: drugs, their mechanisms of action, reactions, side effects, pharmacodynamics, pharmacokinetics, special issues, considerations, contraindications and indications...this is just the drugs, and there's also the physiological issues she'll ask us about, and drug/drug interactions and dosing and what-not...

Final is Monday--pray for me :(

Still on West Coast time

2009-07-13T07:42:00.000-07:00

No matter what I do, I can't get to sleep at a "decent hour."

The other night, the fire alarms kept going off starting at 1:30 am and I think they might have gone off about another 20 or 30 times before morning. I went out for the first one, and the second one. We evacuate the building and stand on the wet sidewalk and watch the tall FDNY saunter into our building with gigantic axes.

Then they saunter out--they knew it was an alarm malfunction, and so did we.

The turn out for the second alarm was much smaller, and less than half an hour after coming in from the second one, the third one went off, then the fourth, fifth, etc.

By that point, I put the pillow over my head and kept sleeping.

It's amazing the things you learn to sleep through.

So, essentially, when I get back to the Bay Area, I won't have any time adjusting to do, since I wake up around 10:00 am here, and go to sleep between 1:00 and 3:00 am.

The weather's been holding out--not too unbearably hot just yet. I'm hoping it holds out for the real heat until the end of the semester, so I can miss most of it.

Anniversaries this week:
Tomorrow marks the one year anniversary of my first biopsy. I remember thinking to myself, "it's Bastille Day...nothing bad happens on Bastille Day."

Wednesday the 16th marks the one year anniversary of getting the phonecall saying the results of the biopsy was "a little bit of cancer, there." I remember thinking how this poor MD was trying to soften in, by saying it was a little bit--something we nurses are taught, clearly, is how not to do this sort of thing to patients--not to give them false hope, not to de-personalize it (it's not "the breast" it's "YOUR breast", etc) Physicians don't get this as part of their training, it seems. I don't hold it against him, I just remember the moment. Clearly.

I had all my hair.
I was in a tee shirt and underpants because the phone woke me--I was sleeping days and working nights. I was kneeling in the doorway to the kitchen, because I had called George on my cell phone to "be with me" while I got the results. He overheard everything.

That day was only just a year ago, yet it seems frozen in time...so long ago, yet only just yesterday. If I had known then just how hard the year ahead was going to be, I don't know if I'd have had the courage to go through with it.

Fortunately, we never have to do more than just one thing at a time, be present in more than just this one moment before us, so it was possible--however, looking back at the whole...makes me want to not look back, much.

I have classes until 8 pm toinght.

I did really badly on my first pharmacology test (got the lowest score in the class) because I didn't know we were having a test--the professors, who pride themselves on sneakiness buried the syllabus with the test dates in a folder called "class files" online, and so I didn't see it (I was looking under "Syllabus" Silly me.

I did significantly better on the midterm, studied my butt off, and now there's only the final to worry about.

Other classes to worry about now are Medical Genetics, in which I have to write a term paper on my pedigree (the tree you draw out from yourself to your great grandparents indicating life-span, illnesses, and death.) Obviously, I have been working with a geneticist at UCSF, and have the information at hand, but the actual writing of the paper is proving to be difficult. I really dislike writing, lately. Maybe it's the subject (cancer in my family genetics) or maybe it's just the APA style formatting that's killing me. I'm not sure.

In any case, I'm counting the days until I can go home!
(Nineteen!)

so this is grad school, eh?

2009-06-25T07:46:00.001-07:00

Well, so far it's been an interesting ride.

I was having a problem with my upstairs neighbor/wrestler/pro-bowler who was running around, crashing into things and so forth bdtween midnight and 6 am. The other night, I didn't get to sleep til 5:30 am, having to call the campus security people twice. I wrote an email to the campus housing coordinator and got a reply back that they wanted to talk to me, so I went in (rather than edit my paper, due that morning) and met with the director of student housing and the coordinator.

They were very sympathetic and nice, and the director said at the end "I'm going to personally go over there and have a talk with them" and they also posted, slid under the door, and mailed notices warning them that they were in violation of the housing contract, etc. Well, whatever she said, it worked. I slept like a baby that night and last night. Though I can still hear someone walking around, it's normal, not loud crashes and bangs and running around like an imbecile at 4:30 am.

Needless to say, my grades have suffered.

I did pretty badly on a test, though, it was mostly because it snuck up on me and I didn't know about it. Though I had been studying, there was not the level of pre-test study that would have normally gone on, so I did very badly.

Another problem I'm having is that I don't know how to write a scholarly paper.
I've received back an assignment and basically they minced it all up...as if I had been a 5 year old and tried to write something.

Partly, this was my fault for trusting the professor when she said it was just an opinion paper about an article we read. So, I found a news article regarding San Francisco's "Healthy SF" initiative, and how Kaiser hospital has just joined, and how great this is.

I got back something that basically said my paper had nothing to do with the article I ahd included. What the...

So, I have to step it up several notches. Lisa doesn't know the meaning of quit.

I'm off today to spend the day at a study cubicle of the library in preparation for my next Advanced Pharmacology exam, and to read about a thousand pages of journal articles that were assigned reading for Genetics and Health and Social Policy classes.

Outside, it's muggy. Overcast and hot--it will likely rain again today.
Only a few weeks now 'til I'm done and can go home!

Was it all a dream?

2009-06-14T19:24:00.000-07:00

Here I am, back in New York. A terrible flight home (more than 3 hours delayed) and an ok flight back, though both were middle seats and I hate those. I guess it's better than the window, though.

I've only been back about half an hour and already I miss George and Rutger so much I want to cry. It didn't seem this bad the first time I came (two weeks ago) but now, maybe because the novelty's worn off, I really just want to be done with this semester and go home for a long while.

My driver, Jose, asked me for advice regarding a friend who had had brain surgery and 4 or 5 days post op had a stroke...what can you say to that? I think people latch on to the fact that you're in health care and just have questions, you know.

I did lots of reading both at home and on the plane, but I bet it wasn't enough. I still don't feel buried but I guess that will come soon enough...tomorrow I have my 8 hour day and then tuesday is my friday. Then I'll hit the bricks running and knock out a few more assignments and so forth.

We have a great big group project/presentation and we chose emergency contraception as a topic...I hate group projects, I hope these guys are good at writing papers because I feel like my skills have waned considerably.

Ah well. Tomorrow is Monday.

It's hot and muggy in New York, but that's a given.

I miss home, too.

But, that's a given, too.

uh oh!

2009-06-10T14:49:00.001-07:00

So, I flew home yesterday.

I spent $700 on one of the last few seats left on a flight direct from JFK to SFO. I called my driver, Jose, and he said it was no problem to pick me up at 6 am, in front of my dorm.

The night before, I was in class. Mondays, my day is 8 solid hours of sitting in lecture, staring at powerpoint slides, as Pink Floyd said "ticking away the moments that make up the dull day..."

I went home, made flashcards of my pharmacology lecture, and had a little dinner. I took breaks to pack my bags (not much packing, really...just text books, and flash cards, and my laptop)

When 3 am rolled around, I knew I had to get some rest, but I was so worried that I would oversleep and miss Jose and my flight. I realized that though I had been there nearly 2 weeks, I had not yet used my alarm clock, a mild-mannered, weak little "tweet-tweet" sort of alarm. I set my phone alarms (all 5 or 6 of them) to buzz and ring as loud as I could make them, and I set the phone under my pillow. I drank a liter of water, ensuring I'd wake up at least a couple times,a nd I slept with the window shade all the way up--hoping light might wake me.

Between the ambulances baking up and the sirens, the thunderstorm that rolled through (WTF?) and my worry, I didn't get more than 20 minutes sleep.

Jose was on time, there was no traffic, and I was waiting at my gate with an hour to spare, relaxedly sipping coffee and having a blueberry scone (all bad carbs)

As soon as we get seated on the plane, the pilot's voice tells us there's a storm ahead of us, and all flights in New York have been grounded. Over the next 3 hours, they came over the intercom to tell us that flight had resumed, only to tell us they had re-halted take offs.

Finally, in the air, with a 6 hour flight in front of me, and a middle row seat, I made the most of it--I read my homework until my eyes gave out, then I napped for 15 minutes, then I started over.

I did all my genetics reading on that 9 hour flight.

I went to the bathroom, however, and discovered I had gotten what looked like my period. GREAT. I haven't had one since December of last year...and NOW??? I have to get one NOW???

So, I started to worry that the tamoxifen I have been taking every other day to start out with did some ovary stimulating (as 10 mg/day seem to do according to my drug book) and when I got home I took another 20 mg pill, though I had taken one the day before. So, now I'm taking it daily as they had intended, and I hope it won't make me sick. I only took it every other day for a little over a week, as my oncologist had recommended starting it.

So, with the delay, I was certain I would miss my dentist's appointment. When we got our first notice of delay, I called the office and let them know I was grounded, and they managed to switch my appointment with someone at 4. At the airport, George met me with my premedication (Amoxicillin mega dose for my Ventricular Septal Defect--to prevent endocarditis from having dental work done...my life sucks)

My dentist takes a look at it and agrees he's glad I came home to have him do the tooth, because now he knows what's under the filling. He said he thought I'd eventually need a crown in a year or so, but that he'd try to do a filling. I love this guy...I'm still walking around with a filling from when I was 16 yeras old, and my old dentist said I needed a root canal, but said, let's try this first, and put something into my tooth to numb it, put a temp filling in and let me walk around with it for a while, then filled it.

I ended up having that filling replaced (it was amalgam) and this dentist (who bought out the practice of my old dentist) said it was barely any tooth...all filling, and that he thought it was amazing it didn't end up needing a root canal. So, that filling has been with me (in two different forms) for 34 years already. I told him I bet the filling he did yesterday would last longer than he thinks it will.

I have to go back today and have another filling put in on the other side (I don't want to take a chance and break another tooth!)

These stupid cavities, I get because I go a long while between flossing--when iwas in ETP, I think I might have flossed 4 times. I get a small cavity between teeth and it goes unnoticed until I'm eating popcorn. I knew about these two, and was going to have them filled a month ago but then Rutger had his seizure and I had to cancel my appointment. I never got it rescheduled so I was planning on coming back in August to do it...little did I know I'd break a tooth and find myself back here emergency-style.

Not off to a good start

2009-06-06T08:50:00.000-07:00

So, I've been doing great in my school work, academically, but I'm not the most lucky of people.

I was chillin' last night, watching an episode of "I'm a Celebrity, get me out of here" online and eating popcorn, when I broke a tooth. I guess I underestimated when the dentist said I had two cavities how bad they were.

So, it doesn't hurt, but I am worried about going to see a dentist here in New York--I've had issues with my VSD (ventricular septal defect) so they make me premedicate with a handfull of amoxicillin, and I have a low blood pressure and I'm usually tachycardic at baseline, so most dentists use Epinephrine in the shot they give you with the novocaine, because it speeds up the absorption, cutting down on your time in the chair, and making them able to move more people through the chair in one day. I can't have the Epi since it makes me so tachycardic that I pass out (no blood perfusion to the brain and I get short of breath, etc)

So, I called my dentist at home, and several other people...my friend Rebecca to ask if she's got a dentist, and the school's emergency health center.

My dentist told me going to an ER won't do it because they'll treat the pain, not fix the problem--so that's out.

So I booked a flight to SFO for tuesday. I have to miss my health and social policies class (and we've got a big group project happening, not good) so I'm sure I will be hurt by going home, but what can I do? I can't wait for it to get impacted or infected.

For now, I am not having any pain and I'm eating soft foods and rinsing with salt water...

Why me?

The First day of School

2009-06-01T06:39:00.000-07:00

This is the view from my window right now--it's 10:00, it looks hot outside, but at least the traffic is light.

As bad as last year was, I thought nothing could be worse--yet somehow, I'm scared of going back to school. Possibly intimidation from knowing these are some heavy courses I'm taking (Medical Genetics, Advanced Pharmacology, and Health and Social Policy.) I've got two days of classes, and Mondays will be my "long day" (classes starting at 1:00 and ending at 8:00 pm without a break for dinner.

I have to go straighten out my registration issues--Friday they confiscated my old ID badge and wouldn't give me a new one until I register. I can't register without the dean of anesthesia signing off on an add/drop slip for me, and I have to go down there and face her (she's a scary dragon) and get my form. Then it will likely be a day of walking around, from building to building, back and forth trying to find the right department and red tape and hoops to jump through.

New York, and specifically, Columbia University, is unlike anything I've ever experienced before.

But I'm here, and I'm alive, so I can't be sad about that (as much as I could be miserable, hating it here, and missing George and Rutger, like the first time around. Somehow, last year's experiences have hardened me--at least it's not cancer, I keep saying to myself.

Still, it's the gepographical equivalent of cancer--New York.

:)

Ok, I had to get one shot at New York in there, somewhere

The End. (it’s not you, it’s me)

2008-02-17T19:00:00.000-08:00

They say all good things must come to an end, yadda yadda. We both knew this day would come.

Over the past couple of years (God, has it really been that long?) I’ve been using this blog to get things off my chest. I’ve shared my hopes, fears, and doubts. I seem to start writing with confusion, but by the time I’ve reached the end of the entry, I’m clearer on what I think about something…how I REALLY feel about something. It’s been cathartic. And I’ve gotten some wonderful feedback and support from my closest friends.

There’s a reason this blog was named “The sleep-deprived ramblings of a former intern architect who decides to return to school to learn to be an anesthetist. (part 1)” It implies there are chapters, with beginnings and ends. A progression forward. Transitions.

I’ve recently come to a crossroads; an epiphany of sorts.

I have been thinking long and hard about what to do come September. Most of what I’ve thought, all the back and forth, has been poured out here, with sincerity, for anyone to read. I’m fairly open about what I think.

I have decided to wrap up this blog. I just need some space, it’s not you, it’s me. I’m not sure if it’s permanent, or a trial separation. But, for now, I am going to try not writing and see if my ability to think and reason things out for myself, without the benefit of the self-indulgent blah-blah-blah that has heretofore been helping me clarify what my own thoughts are.

It somehow just feels like the end of this blog, for reasons I can’t really go into.

I hope you can understand.

My Celebrity Soul Mate is

2008-02-12T15:45:00.000-08:00

George Clooney!
How convenient (since, I think he's pretty hot)
I was praying I wouldn't get Brad Pitt or something.

Take the Quiz

Although, I tried to take it again to post what it said we had in common (besides the sex, I mean) but then I came up with David Beckham.

THREE times.
Don't tell Posh.

(ah here it is: the two of you share a love of practical jokes, classic styles, and ambitious pursuits. Like George, you're creative and focused. Not only are you a dreamer, you're a doer who gets things done.)

No matter how often I do it,

2008-02-12T01:22:00.001-08:00

it's still hard to switch my sleep back and forth.

This completely sucks. I only have to do it one more time, next weekend, for a Saturday Day class. I'm hoping that once I become completely and exclusively lychnobitic again, that I won't be this tired. The funny thing is, now that I'm off orientation, the phone rings off the hook for me to come in and pick up shifts here and there. While I'm still doing day classes, it's not possible, however, since I need these days to switch my sleep back and forth.

And, did I mention how much that sucks?

I went to bed at 10, and the alarm went off at 1 am, and hopefully I will be able to stay up until at the very least, dawn, when I can go get a full 6 hours of sleep.

Luckily, I married the most wonderful man ever, who doesn't think twice about dragging himself out of bed and offering to make me coffee. Sheesh, I wonder, could I do that for him? I'd likely be whining about turing the light off and keeping the racket down--haha...ok, maybe not; I guess I would do the same for him. What did Billy Shakespeare say about Love not being Time's fool? And bearing it out even to the edge of doom. I guess he was talking about Love fading, or changing over time, but I was thinking, after only a couple hours of sleep, I was pretty much Time's fool.

Anyway, I have to stay awake at least another 5 hours. Time's fool, indeed (sigh.)

That Karma's a bitch

2008-02-06T16:09:00.001-08:00

There's nothing you can do to escape your Karma.

Most of you know, I'm Buddhist, and I believe very much in Karma. I've learned that contrary to what I grew up thinking, Karma isn't something that is sown here and reaped in the hereafter, or a next life (for some reason, in my Catholic upbringing, I had learned this as the definition of Karma.) What Karma actually is, by Buddhist definition, is the getting what you deserve in this life. This means, if you go to college and work hard, you will likely be rewarded with a good job, if you work hard in school, you will get good grades, if you are a kind and loving person to those around you, people will return your love and kindness...basically you reap what you sow here, not some afterlife.

Today was a perfect example of this, and it was all I could do to keep from pointing it out.

Remember back to psycho bitch and her nutty breakdown on the floor, yelling and screaming at me as 20 people were in the ICU trying to intubate one of our patients...she not only blurted out that I had confided in her that I was planning on leaving in September, going back to school to finish up the MSN in Nurse Anesthesia, but she went to my nurse manager and had a little whisper chat about how I told her I was looking for a new job. I know this, because I walked up to her office and caught her in the middle of telling her this.

Since then, this psycho has forgotten of our problems, and after two months of silence between us, she's slowly come around to being nice to me and trying to talk to me again. I work with her, I do it for my patient's sake (because in a code, I'm going to need her 4 or 5 year's experience on my side) but I wouldn't trust her with ANY, ANY information about ANYTHING personal of mine ever again.

She's not going to know about it if I have a headache, even.

So this morning as I was leaving, she came storming into the locker room, spouting off about how stupid she was, and how she'd just revealed her intentions to get another job, inadvertently to our nurse manager. Another nurse said to her "so, did you get a second dog?" (referring to this other puppy she was going to adopt) and psycho understood "did you get a second JOB" (which she's told everyone she's looking for"

I guess our nurse manager turned and looked at her and asked her about it.
When she told me this, all I could do was hang my stethoscope in my locker, with a smile, and close it without saying a word.

Karma is a bitch.

Namaste, my friends.

Flyinig Solo

2008-02-05T16:05:00.001-08:00

I walked in last night to find it was just going to be me, my nurse manager, and the freak that went off on me on the floor two months ago (remember? "YOU DON'T LISTEN!!!) So now, I'm officially on my own, no one checking over my shoulder saying "did you remember to check this? did you give that?" and that sort of thing.

Scary.

At least, I got an easy assignment, more or less, the less acute patients because the very accute patient coded three times. Yucky messy codes (what they refer to as a Code Blue AND BROWN)

I of course am a professional and can carry on without a trace of rancor or bitterness for this bitch. (hah) But I think she's psychotic; she doesn't act as if there was anything going on between us--is she crazy? I am polite, and professional, but I still don't make any small talk, and she's probably the last person I'd ever talk to about ANYTHING personal. She can bite me, essentially.

Supah Tuesday.
I went over to the overly chipper bastards manning the polls and cast my vote. As I'm driving home, I hear on NPR that California is on paper ballots because the electronic voting was shown to be vulnerable to computer viruses and therefore nonreliable. What the....I JUST VOTED ELECTRONICALLY...and it was IN California!!!

At this point, the whole system is so corrupt, I don't believe in it anymore. Who knows what the electoral college will do, regardless of what we vote, or who we support and volunteer for and canvas for. This was what I was shocked to learn in political sciences--the electoral college does what it wants, and if you're lucky, they will do what the voters are wanting...they'll watch the polls as they're coming in.

But it's not at all about our votes, sadly. It's not. It would be a better world if the popular vote could decide our elected officials--especially the last 8 years.

un FRICKIN believable...

2008-01-27T21:48:00.000-08:00

So, I am usually off Sundays, and work Monday nights. This gives me two nights (Saturday and Sunday) to get my sleep switched back after Fri-DAY and Satur-DAY classes.

So, I was totally expecting them to screw with me this week. I thought, since the schedule is made up during the days I'm off and in class, I have to call in Sunday nights to make sure (it being the first day of the two week schedle) that I'm not on Sunday night.

Of course not. They screwed me, but nothing so simple.

I'm scheduled TUES/WEDS/THURS.

Think about this: I go to class FRIDAY. DAY of Friday. Thursday night, I suppose I'm expected to come in at 11 pm, work until 8 am, and then magically teleport to Dublin and sit thru an 8 hour class. THEN Drive home for an hour....SURE...I'll be awake.

My strategy is to call my manager tomorrow and tell her it's ok with me, but that I'm going to miss classes this week. Even if I could stay awake thru the class, there's no way I could make a two hour drive fit into a 45 minute window. And...HOW the hell do they expect me to "work" 5 days in a row (if you include the two 8 hour days of classes)

no, no, no.
Why do I let them screw with me?
Unbelievable.

That's my gripe for the day. Every day it's some new shit and I have got to share the ridiculous ones with you, at least...just so you know the myriad ways a newbie gets screwed with.

Beginning of the End?

2008-01-21T00:38:00.001-08:00

I'm worried.

Every time this sort of thing happens I have to wonder--is this it? Are they getting ready to axe me?

I went to class Friday, and again, our Saturday class was cancelled. The difference this week is that they had let us know before hand, so people didn't rent hotel rooms, etc. They also paraded in with a tray full of packages of snack goldfish crackers and rice crispy treats for us, as a way of apologizing for the no-show teacher last Saturday. They are also giving us a free BLS class certificate with no expiration date--big deal, employers usually pay for that. They're letting us use it toward any class we want to take. This is additional to the class we missed, that will be re-offered in February.

So, Saturday, I had a day to do what I wanted/needed to do. I spent the day repotting some plants, and running errands, cleaning, etc. I get a phone call at 11:30 pm, just as I'm napping--trying to switch my sleep back to days for going back to that miserable hospital...Somehow, I've been put in on the schedule for Saturday night.

WHAT?

no, uh...that's a mistake. I have DAY classes friday and saturday, and I usually get ONE day to switch my sleep back...even though class was cancelled today, I still need to switch my sleep. And who the FUCK is going in and making changes to the schedule AFTER it's been posted?! That's not legal!

Ah, of course. It's my nurse manager. How wonderful.
I'm sure I'll be in all sorts of trouble when I go in to work now, for not showing up on a day they originally scheduled me off, so I could go to class...and then chose to write me in.

If they're building a case for firing me, they're starting to piss me off.
I think I'd better write an email and leave a paper trail, just in case.
I'm a little too bitter for writing and hitting "send"

It's shit like this that makes me miss the private sector--as screwed up as that is at times.

Tell me, WHY...

2008-01-16T08:44:00.000-08:00

Why oh WHY do patients code at shift change?

My patient waited until this morning at 7 to start having runs of SVT and the confusion about her code status was all over the place. She's no CPR, but she's on two pressors, the orders said "no new pressors to be started" and on her Kardex it said "no agressive measures" (vague enough for ya? she's on a vent, with pressure control of 54! How much more agressive can it get?)

Long story short, it all started at 7:10, waiting for the nurse that was coming on to take over for me, and the house doc started Diltiazem, atropine and who knows what else was given from the crash cart while I was mixing the dilt drip.

Oy vey, am I ready for a couple days OFF!

same sentiments, opposite coasts

2008-01-13T06:52:00.000-08:00

So, here I am, trying to swtich my sleep back to days. I went to class Friday and Saturday. The drive is 45 miles in one direction (plus bridge toll) and the damned professor is a no show on Saturday--I can't complain, however, because there are people driving for two hours, and staying overnight on friday, paying a hotel for a room with a kitchenette. So unprofessional--her excuse was something about a family emergency and being in the hospital. Couldn't she have called to cancel and saved us all the commute? The school would have called us to tell us, and at least some of us would have been spared the hour plus drive and gas cost.

I don't even know my schedule because it wasn't made up last time I worked, so I'll have to find time to call in and ask when the next day I work is. It won't be tonight since this is my night off after classes--they give me at least one day, sometimes two to make the adjustment. I am counting the days here--I absolutely dread and hate going in to work. Soon I'll be alone, and left to drown, no doubt.

Hearing from another of the anesthesia students via email. She's also unsure about going back to the program, and toying with the idea of just getting an NP and working part time while doing it...quality of life over the next three years, etc.

I knew I wasn't the only one feeling this way (Hating my ICU, doubting Columbia, doubting myself, etc) but it was nice to hear that she's thinking the exact same things I am.

if anyone asks...

2008-01-09T08:55:00.000-08:00

a vodka tonic (very light on the vodka, heavy on the tonic) is exactly like a shot of Nyquil, damnit. That's my stance and I'm sticking to it.

I caught a mother of a headcold and I've been suffering the constant feel of pepper (or pepper spray? Don't taze me, bro!) up my nose and behind my eyes for two days now. I'm ready for it to stop, thank you very much--put me down on the list for "over it."

I have two days off now and I'm trying to swtich my sleep over to nights so I can go to class friday and saturday. It's not even the class I care about anymore, it's the long drive home from Dublin at the end of the class that worries me. I have to stay awake for at least most of it.

So, work is finding new ways to suck--patients are bigger and bigger handfuls and not in the good way--in the "I'm crazy and pull out my IV and bleed all over the floor and bed linens" kind of way. I don't know how ready I'm going to be for New York in September, but I'm fully ready to leave this crap behind.

I go solo in about a month; this should suck even more. Suck squared. Suck to the infinity level. Maximum suckosity.

At least it's a pay check.
The only thing better than a vodka tonic at 9 am is the sleep it brings--and that's where I'm headed kids, head full of mucous, eyes tearing, sneezing my ass off and looking forward to two days off from that ridiculous hospital.

ZZZZZzzzzzzzzzZZZZZZZZzzzzz

"Training"

2008-01-06T01:09:00.001-08:00

Friday and Saturday I went to Duh-blin to attend the Critical Care Nurse training program to which my work is sending me. I have to say that the instructor is a freak.

I thought we'd get along; she's a San Fran native, drives a Prius, and wears Z-coils, so I thought she'd be cool. Turns out, she's nuts and has no ability to distinguish when the lecture has veered from the topic, to the personal lives of the girl from Texas, of whose life we know every detail, or the instructor's life, about which we also know every intimate detail.

I know more about her house, where she lives, how she walks to work, how it was her great grandparent's house, where she works, where she's EVER worked, where she went to school, how she doesn't like UCSF, nearly every conversation she's ever had with anyone in a clinical setting, than I do about ABGs and Ventilators.

It was so hard getting my sleep flipped back to nights so I could be awake during classes in the day--now I see I probably won't have to; being asleep I'll get probably as much out of it. The only reason I'll continue to go is that I get paid as if I were at work, so, I'd rather be there than cleaning shit.

Now I am trying to stay awake again tonight to flip back to nights. I have to work Monday night, and it seems my days off will be mostly used to get my sleep switched and nothing else.

I was worried that before I went off to bed tonight at 7 pm (so I could get up at midnight and stay up all night) because the power cut out right before I went to bed. I lay there, trying to sleep, worrying: how am I going to heat the house, and how am I going to stay awake in the dark!? Thank goodness we had dinner already, but how am I going to make coffee?! I saw myself blogging by candle light until the battery on my laptop crapped out, but then, the gateway wouldn't work...no DSL without power! Oh the humanity!

So let me post this before the power goes out again!
:)

What I've learned watchcing America's Next Top Model

2008-01-02T11:07:00.000-08:00

I'm learning a lot by watching the America's Next Top Model Marathon. This stupid show is addictive. Season after season, the same thing happens. It's caused me to come up with this list of commonalities for each season.

1) I hate Tyra Banks. She's pretty full of herself. Yes, she's pretty. Yes, she was a big deal. But she still inserts herself into every shoot as if she's still a viable model. She's a know-it-all with a very strong personality (sound like anyone you know?)

2) women have a natural tendency to be bitchy, catty, form aliances and gang up on the weakest, most outcast in the group.

3) women, unlike men, have to endure criticism and judgement in their lives. Men don't have this issue as much. Men are judged by their WORK, not for their attitude, personality, looks, etc. Women, no matter what they do, who they are, have to endure the judgement on their personality--so odd.

By far, the hardest thing about nursing is making the transition to a female dominated environment. My mother was nothing like this, and I only had one best friend growing up so I am missing a lot of that dynamic. It's like being thrown into a top dollar poker game, with sharks, and learning the game as you go along...vicious.

I know I'm going to eventually make it, but the growing pains are fierce. I feel like writing a book "my year as a woman" or something like this. I don't suppose anyone would read it, but I think my perspective is different.

Anyway, this is a year for major change and betterment, to be sure!

Oh eight!

2008-01-01T10:54:00.000-08:00

Well, 2007 was SOME year!

2007-12-31T16:03:00.000-08:00

I have to keep reminding myself that last year in NY was terrible, but in retrospect, it seems to have gone by rather quickly. It seems that this year is dragging, I have 8 more months left at this ICU.

It's sort of funny how "year" means academic year and not calander year to me. I have all these thoughts about what 2008 will be like. So much has happened in '07.

I went back to NY in January. I graduated from Columbia. I passed the NCLEX and became a nurse. I got a job and started earning real money for the first time in about 5 years. It's kind of been a very transitional year. I wonder what 2008 will bring.

I'm hoping it will bring further organization to the house. I'm hoping it will bring some real Acute Care knowledge. I hope it will bring a return to school, to finish the anesthesia program, I hope it brings a Prius, I hope it brings a sense of well-being and happiness...I hope it brings peace in the mid-east, and a better president (though, that's not going to be hard...pretty much a potted plant would be better at this point!)

I hope to be less tired in 08, healthier, happier, wiser.
I hope the same for you, too.

ZZZZzzzzzzz.....

2007-12-30T18:01:00.000-08:00

Gah, I just woke up from a mid afternoon "nap" and good-golly, it's hard to swtich back to being awake in the days! My body just doesn't want to move. "SLEEP!" it says, "sleep NOW"

How the hell am I ever going to go to classes in the day? For one thing, G wants to take fridays off to drive me because he's afraid (seeing me the way I am and how tired I am) of how I'm going to be able to get behind the wheel and drive like this. I can't.

It's things like this that make me bitter and resentful about my work. Why wait until I'm on nights and force me to have to change back and forth to nights and days intermittently?

I need to start finding something positive in my life, because right now it's complete crap. I'm tired all the time. I have four days off and I've spent the first two completely exhausted. I mean exhausted in the true sense, not like "I'm a little drowsy." I mean, I can't lift my arms and legs at my will. My eye lids won't open. I can think words, but can't get my face to move to make words. THAT kind of tired.

One thing that was nice; today I heard from a friend whom I haven't spoken to in a long while. She's going to be taking the NCLEX in a few days and it was funny to hear the same exact worries and thoughts coming from her as when I took it. I remember feeling the exact same way: I just want it to be over. I know she'll do well as she's brilliant and is going to be a kick-ass nurse. (Go L, go!)

2007-12-30T02:46:00.000-08:00

This sucks.
I have 4 days off, then I'm supposed to work one, then have two days off, then go to classes in the day time when I'm usually asleep now, for two days. Monday I'm going to call in to ask my charge if she cares that I take the one day off...it's impossible to switch my sleeping back and forth from days to nights.

I tried yesterday to stay up as long as I could--we went grocery shopping and so forth. I crashed out at 1:00 in the afternoon. I had hoped to take just a short nap, but it was horrible to wake up. Poor G was trying for over an hour and I was fighting it like crazy. I've never, ever been so tired. My muscles won't move, I can't move--it's like I've been injected with Succinyl Choline (a paralytic) and I can think about moving, but not actually move.

It's horrible. For a month and a half, I have to do this swithching back and forth?!
God I was so hoping I could start at UCSF and then blow these bastards off. This is torture. I can't even imagine driving like this--and the classes are over an hour away by car, in Dublin.

So, I slept for a few hours, and wake up at 2 am, and now I want to just surf the net and find a new job. Kaiser, anywhere--I just feel like I need to leave.

If disillusionment were a musical instrument playing, you'd hear a symphony coming from me right now.

(sob)

Well, THAT was a waste of time...

2007-12-28T10:46:00.000-08:00

So, I pack my professional atire, stealthily in a big bag and cram it in my locker, complete with shoes, belt, and make up. I leave work on time for once and bolt outta there, down to a random bathroom on the first floor. I dress in one of the stalls, cram my scrubs in my bag, and put some make up on to make myself look alive and run off for my car before anyone I know sees me all dressed in street clothes--it would be SUCH a giveaway.

I get there half an hour early. I wait around. Holy crap--this ICU was jumping (9 Moffet) Every time the doors opened up, there were people swarming, the unit clerk was always busy, there were people in and out, like a bee hive. So different than my little joke of an ICU.

When I met with T and C, they asked me to tell them about myself. So, I did, briefly. Why this unit? Well...blah blah... T stops me and says it's the most acute ICU in the whole hospital, that they have ICU nurses floating from other ICUs and that they get bent out of shape about being there. I listen, I nod. It then becomes clear that they're meeting with me only as a courtesy to their co-worker whom I forwarded my resume and asked for her help.

It appears they want me in a year, or more. So, I have no frigging idea how one gets into the critical care training program at UCSF, but I'm getting tired of applying and getting rejected by these bastards. They did say that they called me because I'm mature, I am a second career nurse, and as such, I know what I want to be doing and I'm not going to be flakey (little do they know!) I thought to myself--this is the type of ICU I should be at for a year, working to get ready for going back to Columbia. These are the nurses I'm going to be elbow to elbow with if I do go back, not the ridiculous silly nurses at my ICU. And here I am, unable to even get in.

At this rate, the only way I'm getting into an ICU here in the bay area is if I have an organ transplanted myself.

So I'm stuck at this hell-hole in San Mateo, with the 7 beds, and patients that are so stable they might as well be at long term care (and I don't know why some of them aren't!)

I'm pretty frustrated right now. Even if I go back to New York, this is clear what type of ICU they had hopes of me being at for a year, and my ICU is far from it. I won't be ready--and I might as well save myself the tuition and airfare, because they'll just send my ass back asap.

I'm going to bed.
Maybe I'll cry a bit--I haven't decided yet.
Probably not, I'm pretty tired.

YAHOOOOOOOO!!!!

2007-12-27T09:51:00.000-08:00

I just got off the phone with someone from UCSF, I have an interview tomorrow!!!

YEEEE HAAAAAAA!!

I work tonight, so I will have to leave work, find a bathroom on the first floor, change clothes quickly, drive over to UCSF and apply my face in the car with whatever time is left (adjustable makeup, can put on minimum or do a good job--after this many years, you learn a few things)

So, I could very easily have a new job before the end of the year, if they let me know at the interview (as this place did.) The thing is, I'd like to be able to give notice BEFORE starting those courses they signed me up for in January (the 4th!) so as to be fair and allow them to get a refund. I could be a bitch and let them pay for that training, get paid while going to the classes, and THEN quit, but I'm a nice gal...I want to be fair. I could easily milk another few thousand bucks out of them by working right up until UCSF would want me, around when they'd be expecting I'd be off orientation, but they're going to extend me until these classes are over.

Oh, my nurse manager is going to be PISSED.

The sad thing is, they're so short staffed. Last night, a day person was working nights and having a rough time staying awake, and in the morning an evening person came in during the days when she's normally there in the late afternoon/evening...and I heard our charge nurse went to work a night shift two nights ago because someone called in sick.

We have two people out sick, one pregnant and sick, and another person just quit (whom I liked but everyone else hated) and a traveler that's leaving (whom they also said they hate, but to her face they're nice) so...I'm sure no one will shed any tears when I leave. Sadly, now, I'm in good with the night crew and they've been very nice to me--the bottom line is I haven't learned any acute care. And THAT is what is driving me to leave. UCSF has an AWESOME program, sort of like what I left at Columbia--classroom-wise, so it's more class plus clinical. At this hospital, I've learned only bedside skills--how to change an IV tubing, what amount of days the tubings are good for, how to draw labs, placing an IV, trach care, etc. People stay at this place because it's easy; because it's a good paying job and for an ICU it's not so bad, but this is exactly what you don't want as preparation for anesthesia...you want to have busy, acute, very sick unstable patients, and only THEN are you ready to start learning about anesthesia. (or so I hear)

The thing is, this would automaticallly put me out of the running for returning to Columbia 2008 in the Fall, as I would have to agree to working at least a year. But the training is so good, I wouldn't mind. I'd almost fear going back without the training...anesthesia is no joke--if I know jack shit about acute care, there's no way I can fake my way thru--nor would I want to. This place keeps telling me it will come with time, but my experience is that it's better to get classroom type teaching, rather than throw me at it and learn as I go teaching.

They don't love me here, and I'm not pulling my weight, but they're hoping I will start soon...

Oh, and I've been like the UN in translational services for them. Besides using my Spanish daily, we had a patient last night who is a tourist from Italy and doesn't speak a word of English. Poor thing--he put his asthma meds in his checked bag and they lost it, so he had a massive asthma attack and ended up in our ICU. So after ten plus years, I got to brush off some Italian and boy have I forgotten a ton.

Maybe in the next week a deaf patient will come in and I'll be able to try my hand at ASL again (pardon the pun)

Alrighty, kids. I'm excited about this interview tomorrow--wish me luck!!!
:D

Resolutions

2007-12-26T03:53:00.001-08:00

I've always hated New Year's resolutions. Even if I was a stick figure, it would always be to lose a few pounds, to take better care of my appearance--dress better, make sure I did my hair and makeup always...always those self-esteem type resolutions.

I lost about 20 pounds of that stuff that creeps up on you a pound per year after returning to the bay area. It wasn't hard at all, really--just cut out all refined foods, white flour, white rice, etc and exercised a little bit a couple times per week. I've put about two pounds back on since I started working, you know how bad nurses eat--candy, cookies, cake, fried foods, so yeah, I guess I'm resolving to lose those two pounds, but honestly, I could drop those before the end of the year without much effort or sacrifice; I'm not worried about two pounds.

I would like to get a haircut before the new year, only because I have a party to go to and don't want to be a shaggy mess.

So in this sense, I guess I do still have some appearance-related resolutions, if you can call them that.

My resolutions have gone by the way side. I think I resolved one year to not have any resolutions. Like the time I gave up Catholicism for lent. The nuns didn't like THAT

Anyway, I've been hankering to do something creative again. I think I'm going to resolve on either getting some of my crap paintings finished and shown, or better yet, print up and frame some of my slides from Europe to have a small show/salon. I once went to a small show put on by a friend of a friend, of all these really bad amateur photos of her trip to Italy. She sold the show out and I was left with my chin hanging on the drive home. No eye for composition, zero processing...plain old enlargements! Crazy.

I think I'm going to start working on something like this in the wee small hours. I'd love to make some extra cash, but I'm aware that I'll probably (at best) break even.

Anyway, these are the crazy ideas I have when I'm baking and cooking from 11 pm to 6 am. Tonight I made a huge batch of pasta sauce, my week's supply of steel cut oats, scones, cracked wheat bread, and rice with steamed veggies for the quick "leftover re-heat" before going off to work.

maybe it's the creativity in the kitchen that's pointing me in this direction; the drive to do something creatively meaningful.

The only problem is that I shot 35 mm slide film in Europe, which was at the time, the best resolution you could get outside of a large format camera (impractical for travel) and though I have a light box, I don't have a slide scanner any more, in order to crop and fix my images before printing. This would leave me with a lot of printing instructions for the photo lab (and a lot of room for them to make mistakes, if you ask me) so this would kinda suck. I'm wondering how to get this remedied.

Anyway, I would love to even make the invitations for this--I'd probably make up about 500 4x6 cards and send them to everyone I know. I'll also, of course, have to come up with an artist's resume (gonna be pretty short) of the type they hang at galleries so you know about the artist. I don't want a webpage because this, I've decided, is for people who are trying to attract business, and make a name for themselves and get hired. I may, at most, set up an email list for notifying people of upcoming shows (if I ever have a second one, that is!)

So there you have it, the wheels in my pea brain are turning. I'd love to actually do this and it's not that far-fetched, really. People always buy photographic art and I could do all the framing myself with stuff I have around here (from the framing days) I think photography sells better than large format canvases I was doing a few years ago, so I won't focus on those for now.

I have enough slides for now (around a thousand) to have a massive show, but since I need to have these printed up professionally, it would be expensive to do them all.

So besides a slide scanner, a place to actually hang, a professional, good-quality printer that won't charge me an arm and a leg, this could happen! :)

I almost made it

2007-12-24T22:01:00.000-08:00

thru the damned holidays, I mean.

I worked last night and that was no big whoop. The night crew is being nicer to me lately, and more supportive...I suppose that they've accepted me, though I heard a rumor that I was looking for another job...gee--I wonder what skank spilled THAT secret of mine, eh?

So, today is christmas eve, and I just woke up because I had to stay up "late" (I was up until almost noon!) and so that pushed my sleep schedule back.

We bought one gift this year, for our next door neighbors, whom have lived next door to us since before I was born--a sweet old Chinese couple. We went over there this morning after I came home from work to exchange gifts with them--a reciprocal exchange of chocolates, ha ha. Then we went to pick up some floweers as I became acutely sad and missed my family. The closest thing I have to family now is my brother's grave, about a mile away.

I went and put some flowers on his grave.

I thought about how much he really made Christmas...he was the most excited person in the family with the holiday spirit filling him like some form of retail mania. He always went way, way overboard and spent way too much money and bought everyone those huge ticket gifts that made everyone feel like he was insane. He never cared about money, it was the holidays and you needed to have whatever your heart's desires were at that time, even if you hadn't even dreamed so big.

I am not sure if I cried because I miss him, or if I cried because of how lonely I've become since he and my mom have died. The thought of what the holidays used to be, versus the way they are now--it's sad. I suppose that in time, we'll have to start making some effort to "celebrate" in some fashion, but it's currently just not in us. Every day is the same as any other day...no special occasions, no holidays...perhaps it's from having been in school for so long, and having to be away for birthdays and anniversaries, or maybe it's that I have to work a lot during days I consider special--like anniversaries of the death of my mom or brother, or my husband's birthday, or my own.

I thought I had survived the holidays without shedding a tear, but today I didn't make it. I suppose tomorrow we'll dust ourselves off and maybe try to go somewhere and do something "together" just the three of us (me, husband and dog.) Perhaps a picnic or something...a walk somewhere. Not sure yet.

I'm trying to find something positive in all this. I feel so down. Everything feels like shit right now--like it's raining down crap, always.

On a depressing note, I heard on NPR today that our economy is so crap that people from other countries have been flooding in for the holidays to spend spend spend, becuase the dollar is so weak against their currency. Yes, CANDADIANS are now coming over the border, the Japanese (as ever since the Yen is always strong, but even MORESO now) and Europeans have been coming to spend their money here to buy buy buy (that's good, I guess) buying up every Ipod they can get their hands on, and so forth. While this is good for retail and for the hotel and restaurant industries, I still can't help but feel sad about how low we've fallen. I also heard that there's talk among OPEC to change the currency of trade for oil to the Euro. If this happens, we're screwed.

I've GOT to get my EU citizenship thing going. I don't see this having a quick fix any time soon.

Happy Holidays!

2007-12-23T20:13:00.000-08:00

I'm working tonight, and then have two days off, and so does G, which is nice!
I'm actually looking forward to having a couple days off.

I'm getting along better with the nurses at night. The Cinnamon rolls made me some friends. The next night, another nurse brought take out for all of us, and we all eat together. I find this very different than the day shift, which was colder and a bit more exclusive. Right now, you couldn't pay me to go back to day shift.

On top of that, I'm getting between three and four hundred bucks per check more just for working nights. Add to that the lack of stress from having the phone ringing constantly, having family members calling and coming in, taking up what little time I have asking questions...and you want to be able to explain things to them, but often, you have just enough time to do your thing and get out of there only ONE hour late instead of two or three...and the amount of extra staff around, bugging. I so don't miss days.

I miss my days, however. I do miss the sun, and being awake during the day, sleeping at night when it's dark and cold--that I do miss. I miss being on the same schedule as my hubby and dog (believe it or not, the dog is acting like he misses me too, and doesn't "get" when I leave for work at night, or why I stay up on my nights off)

So I'm looking forward to the next two days off. Maybe we'll take a ride somewhere, or do a picnic in the VW at the beach.

Some good news...

2007-12-21T04:48:00.000-08:00

I don't know if I mentioned that the person teaching a couple of the courses my work was sending me to, at UCSF, noticed me sitting in the front row (nerd), in my Columbia hoodie (I went to an ivy league and all I have to show for it is this hoodie?)

She asked me if I had really gone to Columbia, or if someone had just bought me the hoodie. I offered to show her my Sallie Mae Loan statements, and she laughed. It turned out that she got her MSN at Columbia. A fellow alumna!

Cut to three or four months later, and me applying online to the stupid critical care program (again!) and not hearing much in return. I finally emailed this fellow alumna of mine and asked her if she remembered me, and if she could help me get my resume to the right hands so as to at least not miss this again.

Well, I just noticed on my phone yesterday morning that they had called and left me a message saying they'd like to interview me, that this alumna of mine had forwarded them my resume. How awesome is that?!

I left them a message saying I'd be very interested in meeting with them.

How cool!

I'm now worrying about having to go in and tell my nurse manager, who's being a LOT nicer to me since this whole blow out, that I'm going to take another offer...just as the training they're going to send me to is either in full swing, or just over.

Sheesh.

But I can't count on getting this other job, so I have to move forward at this current ICU as if I don't have any intentions of leaving. To make matters worse, a friend in NYC has been emailing me about her doubts about this program, and virtually, her emails read exactly like my blog. Holy cats, we're saying the same things. Maybe I'll just go and do the NP thing...maybe I'll stay at Columbia...maybe I'll apply somewhere else, I hate my icu, etc.

Hate's a strong word. I'm baking about 4 dozen cinnamon rolls from scratch, some of which will make it to my work tomorrow night, afterall. Funny how much I'm baking/cooking at night to keep the upstairs warm. I just can seem to wake up in the late afternoon and cook, so I have to do it while I'm up...otherwise, no one eats around here!

Gah...I just picked up "The Grapes of Wrath" the other day at the thrift store (while I was killing time until I could park in front of my house after the street cleaner goes by, so I duck into the thrift store and browse their bookshelf) and NOW it's on AMC. I had just gotten to the part where Tom Joad gets back to his farm and it's all abandoned because the banks have forclosed on his parents and neighbors. Funny how many people have made such sacrifices to get to California, my parents included, and here I am whining about what? Having a decent wage? and a roof over my head? bah. I'm a sissy.

When I was in Italy, my "Liebemeister" (beloved professor) likened me to the woman in this story. In Italian, it was called "Il Furore" and I remember going to great lengths to find out this was "Grapes of Wrath." Now I wonder which character he meant. There are two strong female characters, Ma, and Rose of Sharon. I actually feel more like Tom Joad, but that's no surprise, he's a bit disillusioned, and focused only on the present because the future is so out of grasp...I feel a lot like that guy.

Click here for a good Sparknotes review of characters

I'm off to sample one of these cinnamon rolls, eh?
Just wanted to update youse on the good news :)
Keep your fingers crossed that I won't blow the interview, or leave the frying pan for the fire, huh?

:P

Here I am again

2007-12-17T02:06:00.001-08:00

Just me and you, up late. Although, you might be reading this during decent hours...
(sigh)

I've gotten so used to the hours it's sort of sad. When the doorbell rings, and it's a package delivery, I am virtually blinded by the daylight when I open the door. The UPS guy must think I'm a crackhead. The other day I came upstairs and was blinded by the 4:30 pm sun. Pathetic.

I'm Dracula, evidently. If this were "olden times" I'd have villagers at the door with pitchforks and torches by now.

Anywho--here I am. This wouldn't be so hard if it weren't winter. It's dang cold in the house, and the downstairs bedroom gets so hot with the heat on, so we leave it off all night long. So, to offset the cold, I bake things. My husband must think he married a Keebler elf since he wakes up to scones, bread, cookies and all sorts of other crap that is bad for our waistlines. I try to be wholesome about it, whole wheat, organic whole grains, etc, but you know...it's still cookies.

Anyway, my point tonight is this:

I'll get to it in a minute.

We were talking about a mutual friend who was laid off around the start of the year. He's undecided on what he wants to do--so he does nothing. His situation makes me think. I've been there, and I was at the same crossroads. Lately, the difficulties I've had adapting to women in the workplace have made me wonder if I've made a mistake. Last night I was sketching out the changes I want to make in the kitchen--a sudden peace came over me as I lost myself in design (and I wasn't really even getting that far into it.) Somehow, moving lines around was calming. I was happy for a moment. The thought that tomorrow night I will have to go back into that den of vipers and hold in all the comments I'm thinking, while they openly insult me, chide or belittle me, makes me a bit queezy.

It's only for a year. I'm almost a third of the way through. I've been through worse, I'm not complaining, really. I just smile and think that soon I'll be gone, and on to better things.

There's only a couple weeks left in the year.

Incredible.

I think back to last year...slogging it out in New York, going to sleep at 2:30, getting up at 4:00, standing in the bitter cold waiting for the shuttle to Cornell, missing home, at least now I'm home. At least now I can occasionally see my husband and dog. What could be better?

:)

ok, so now my point: I was thinking about this friend of ours, and how nice it was to have a sharpened lead in my hand, and sketch paper, and to be using my creativity. I realized how much my spirit has been sapped at this place. I used to have some ideas rolling around up there, in my brain case, before I was a bitch, or a dumbass, take your pick.

So, I thought about some of my ideas that have fallen off the back of the stove, while being back-burnered.

I wanted to buy an apartment in Florence, Italy, and have the sort of life that would allow me to go there at least a few months out of the year. Now all I think about is paying off my debt. Or rather, how long that's gonna take.

I wanted to write a book. I still don't want to jinx it by talking about it, but it was a study of the Italian Piazza, done to the level of architectural research projects...I was just hoping to make enough money to pay for the apartment, actually...that would have been cool.

I wanted to patent something--I have a design, and some sketches, but I have never filled out the forms needed for this.

It's funny how now all I want is to learn as much as I can at this place, enough to make people stop hating me or even one better: enough to go back to Columbia.

I used to be one of those big thinkers. Anything was possible if I set my mind to it. Now I've let those vipers gnaw away at my self-confidence, my self-image...this sucks.

I'm trying so hard to regain/retain any little part of my creative self...but god damnit...it's so hard.

Not that architecture was great; it sucked balls at times.
Here's a picture of Thom Mayne, one of the creators of Sci-Arc (the school) the Santa Monica Style, and the firm Morphosis.

He once made one of my classmates cry when he said, during his critique, "where is the architecture!? if you're going to tell me this is architecture, I say BULLSHIT!! This..this...STUCCO CRAP!! How is this any DIFFERENT than ANYTHING that is out there now?! What PROBLEMS have you SOLVED!? HM? What PROBLEMS? (my classmate looked at his model here, bottom lip quivering) I say BULLSHIT!!! Architecture is your WORST ENEMY!!"

Wow, that was some harsh jury he had that day. So, I can suffer a bunch of insecure vipers, and their petty jabs. Any day.

Really, this ain't shit. I've made it through way worse.

I'm either a bitch...

2007-12-14T20:52:00.000-08:00

or a dumb-ass.

Those were my two choices last night. I had to choose one. "I suppose I'm a bitch then, but...are these the only two choices there are?" I asked my preceptor, Marie.

"Yup."
"huh. I suppose then that I'm a bitch, but which of the two are you?"

:D

Ah, I'm so not concerned anymore about friendship or being liked.
When you're going to call me a bitch to my face, then we know there are issues.

Two nights ago, they were lamenting our traveler, Amanda renewing for another month.
"How long has she been here?"
"TOO Long!"

Yikes.
They hate her. She fills out incident reports for patients coming up from the ED needing to use a urinal. WTF? She also is a freak because she has tattoos and eats fire. Yes. She eats fire like in the circus. They talked about her for about an hour and said they can't wait for her to leave, she's not a good nurse, she does everything wrong...yadda yadda.

I worked with her last night. Of course, to her FACE they say "well, you're WEIRD, but we still LIKE YOU..." Holy cats...they like her? What was with all the talk last night then!?

With friends like these...

The one preceptor I worked with two nights ago, Josie, told me that night that that was probably her last night there. She was going to tend resignation, but call in sick for two weeks after that. She was cool--she was the one that verified I was right in that issue with the syringe and Andrea the nut. She gave me lots of good advice, and we talked about when she lost her husband to Leukemia three years ago--having lost my brother, we had that in common.

I was sad to hear she was leaving, but I knew it was this catty place, how they treat her and make her feel like an outsider...I knew first hand.

So last night, they were all catty about her leaving. She cleaned out her locker and left it open...an odd move, I thought. I'd have closed it and made a quiet escape--she chose to leave it wide open, almost signaling that she will not be back.

This place.
I sincerely hope I get into another ICU.
I start classes around the start of the new year. Yeah, I have to switch back and forth to days and nights for school and work in the same week. Why the hell didn't they get me into a class situation while I was on flipping days?!

Whatever.
Last night I had a patient with intracranial bleed and fractured skull in one room, and in the other room, a patient with bacterial meningitis. Neuro, Neuro, Neuro.
The one thing about this place that's good is the variety of stuff I'm seeing. It's a small ICU, and catty, but the patients are super sick. (and, that's a good thing?)

Still, this is a place I'm honing skills and that's all. Learning the ropes, and figuring out how (for the first time in my life) to deal with women.

Fuck. Women are hard. Harder than anything I've ever had to deal with. My girl friends are so not like these bitches. Is it me? it must be me, right? This place is working on my confidence, and self image. I hate how women can do this even though you know they are doing it and you try to not let it effect you.

I'm hoping it's just another month or two...three tops at this place.
Time to start praying.

bad--> worse--> intolerable!

2007-12-12T00:28:00.000-08:00

oh my, where to begin?
it was so bad I couldn't bring myself to write about it.
It was like Hiroshima, in female crazy form.

I'll give you the short version:

I ask a lot of questions, I know this. This will clue you in to how untrained I am, or rather, how little training I'm getting: they paired me up with Andrea, the girl they hired after me, who has a handful of years experience in ER. She seemed cool at first, very willing to offer up stuff that other people just did without telling me why.

On the 4th, they brought back one of my patients who had gone down to the floor--he was in ARD (acute respiratory distress) and they were fixing to intubate him again. It was tense in the room, and she's putting in a peripheral IV and while she's talking to me, saying "see, you never want to push with anything bigger than a 3 cc syringe because you'll blow the end of the catheter off, you have to push with the smaller syringe..." the doc is trying to get her attention and finally yells "Hey!" at her.

Really, not a time to be teaching me, she could have told me this later.

Outside the room, I asked her about what she had said because it had gone contrary to what I learned from ICU skills day, and the PICC line nurse: NEVER push with anything SMALLER than a 12 cc syringe, or you'll blow the end of the PICC out.

Which was right?

She kept insisting that that's a picc line, and piccs end up in the heart, yadda yadda, she was talking about peripherals, not piccs, and explaining to me what a peripheral is, and what a picc is--for fuck's sake, woman...I know what the difference is.

"I understand that much, my question lies farther up, at the syringe. It's a matter of physics. The broader area of the bigger syringe pushes with less force."

Pressure (P) = Force (F) divided by Area (A)
P=F/A

Am I crazy? or are, in her peripheral, the laws of physics reversed?

I tried to nod and say "yes, I see...uh huh" but I kept coming back to one of these logics is wrong. When she got a little heated up, and starting getting a bit insulting, I backed down and said "ok, this is just one of those things I'll have to just remember as such"

She blew fucking up. "You know what your problem is?! YOU DON'T LISTEN!! you need to SHUT up and LISTEN! you're so STUBBORN!! Everyone KNOWS you are not happy here! YOU have a BAD ATTITUDE and you are a NEGATIVE PERSON!! You need to LISTEN!!! nothing MORE!!!"

Wow.
What a fucking bitch.

you know when you make what you think is a friend, and you confide things in them, the sort of things like "I'm not happy here" and then they blurt that shit out on the floor, with 20 people around?

yeah.

So--this bitch then went in, trying to be sneaky, to talk to the charge nurse in the morning. I was trying to do the same, lingering and so was she--straightening things, etc. So, I let her--then I snuck up to the office and said "oh, and when you're done, could I also have a word with you?"

Bwah ha ha!

So, my charge sat us both down and we started talking about what had happened. Initially, it seemed she was taking her side, and insisting that I not question my preceptors--what I need is skills not anything else. THIS is what I need to learn, in her eyes. Half way thru it all, she seemed to switch camps and take my side. My real concern, and source of unhappiness, I told my charge, is that I'm getting paperwork and policy, and not any acute care, and I'm worried that in a month they're going to turn me loose, with no acute care knowledge and I'm going to be responsible for someone's death. She understood this and reassured me that this wasn't going to happen. Nut job also nodded supportingly and said "yes, you can always ask one of us...WE'RE here for you (fake smile)"

"can we work together?" my charge asked in the end.
Of course we can. I don't have a problem.

Psycho was of course, a big phoney, smiling and acting like she'd been supportive and kind thru the whole thing--smiling and acting like it had been me that had blown up. Bitch please. All I did was try to get you to calm down, and stick to the point. You were insulting. "I never said that"

"well, there were about 20 people out there who overheard the whole thing...we could easily get one of them to come in here and talk about who said what"

hah.

So, this isn't even the bad part: I left, and the bitch was hanging out by the ER door, where we exit. "are you ok?"

"not really. I don't like what you did there. Blurting out shit I had said to you in confidence was not cool at all."

"EVERYBODY KNOWS YOU'RE NOT HAPPY HERE!" blah blah...on and on she went in her tirade. I just kept walking. You're no friend, I thought, and I will work with you, but talking to you outside anything that's not directly work related is OVER.

She says then "Well, I'm not going to preceptor you anymore, then!"

Is she serious?
I wanted to laugh, but it was clear she's nuts, so I just let it roll off me like water off a duck. I went to my car and wondered if she's capable of knifing my tires, or keying my car. I wanted to call my charge and tell her screwball had cornered me in the lot, and what she'd said, but I let it go. I talked to my charge the following morning and told her I didn't want to call her, that I knew crazy would and that she was probably up to "here" with all of it because I sure am; it's not in my vocabulary to do this kind of crap and I am tired of it myself. My charge nodded and said she appreciated it, and she's been on my side ever since.

The following day, I kept my smile on, and didn't talk to crazy. She ignored me too, which was fine. I worked with someone who gave me all sorts of cool tips on lab values and what to anticipate, etc. The first person to actually teach me anything acute care!

The following night, I worked with the Philipinas--I brought it up, smiling, about how much of a problem I start when I ask questtions--they were dying to ask but weren't going to. I told them what happened and they rolled their eyes and said "Duh, you made her feel stupid--she's wrong. It's like you say--the bigger syringe pushes with less force, but she didn't have anything but to get mad at you; just ignore her"

BWAH HAHAHA!!

I made a joke that I wasn't going to ask any more questions, and when I do, I smile and say "now, don't go crazy on me if you think I'm asking you too many questions, but..." and they laugh. I've gotten nothing but support over this now.

And, my charge told me that she's signed me up for a critical care course in January/February, but it's all the way out in Dublin. (fucking hell, what a commute)

Things I should have taken into consideration:
Last night, this crazy bitch admitted to being just over her period--last week was PMS.

Also, she's planning a wedding--talk about stress. All she talks about is dresses, and flowers, and so forth.

When I had told her I was in the anesthesia program at Columbia but wasn't going back, she said to try Merritt. "Sure," I said, "Imagine my resume and yours hit their desk next year...who's is more impressive? I have no chance of getting in"

"Oh, you'd be surprised, I went there to talk to them about the CRNA program and what they care about more is GPA and GRE scores. You mean to tell me that if I know the area of a triangle that's more important than being a good nurse?!"

The area of a triangle...is that what she thinks the GRE is? She told me she bombed. I told her I did ok on it, but that experience was lacking for me to be eligible. She disagreed. So she wanted to do what I'm doing, but couldn't.

Ah, the green monster and I didn't even see it.

Anyway--that was the drama.

We work together, but we don't shoot the shit anymore. No words exchanged that aren't required. There's no room in my life for backstabbers or nuts, so I'm not worried about it. I treat her cordially, smile and do talk to her when it's needed, but apart from that, screw her.

Aren't you glad you're not me?

Here I go again

2007-12-03T11:03:00.001-08:00

I've been up since about 10 am (that's my sleepy time, I should be asleep until about 3 PM) trolling the AANA website looking for alternate routes. What hope have I got of getting into a program with 3 months under my belt? I even saw one that was deadline for application Dec 1st, with entry date of January 2009!

2009!? that means if I apply NEXT December 1st (2008), that will be a 2010 entry?!

Holy crap.

Some require a minimum of 2 years ICU experience at time of application, some require a B in statistics, others a cumulative score of 1000 on the GRE, some require 3 reference letters, and some want a GPA of 3.2 or better. So I'd have to impress people somehow, quickly to get the reference letters (unlikely) retake statistics (I crammed it in 6 weeks and got a C) I'm borderline on everything else. I think I scored JUST over 1000 cumulative, I have exactly a 3.25 from Columbia (stupid labor and delivery professor ruined my gpa.)

One school wants you to be licenced in not only their state, but the neighboring state (and neither of them is California, so I'd have to have licences to practice in 3 states)

Last night, I was trying to stay awake, but crashed out around 11. "It's a nap" I thought, but as soon as I was alone in front of the TV, I zonked out. I kept waking up every hour or so, trying to sit up, pay attention to the TV (all the adult swim shows were on) I made coffee but I kept falling back to sleep. I finally caved in at 6 am and went to bed because it was so cold in the house, that I just wanted to crawl into the warm bed. I work tonight, so I will be good and screwed tonight if I can't take a nap before going to work--don't know how I will make it through the night. I'm already dreading every shift at this place. It's always bad. I hate it when I hate my job. This is a sure sign I need to move on.

I've been off for almost a week now. 6 Days.

I had been scheduled to go in Wednesday, but they had signed me up for a DAY class at UCSF, and that screwed my sleep all up. Then I called in sick for the following night because I felt like crap, and was so tired still from the 4 days' abuse they put me through the previous week (admit and discharge in the same shift...screw you guys) Then I had Saturday and Sunday off. I had been scheduled to go to another class today, but I work tonight and can't see calling in sick again--they'd crucify me. So, I'm just not going to go to the class. They'll give me crap about it, but I have no room number, location to find this class, just the time and date the class was to start, and they are scheduling me all over the classes so it would be very difficult to attend AND go to work; get it together people, it's not so hard.

Now I go back, completely unmotivated, and unwanting to be there. I keep checking my email to see if UCSF has written back, but no. They probably won't until around mid-January is my guess. I've only ever hated my job twice in my life, and I don't like when I hate my job. It's a miserable feeling.

I was watching...

2007-12-02T00:48:00.000-08:00

"Two Weeks Notice" (god-awful Sandra Bullock/Hugh Grant movie) set in New York.

I never get tired of this joke: wait until there's some GORGEOUS view of NY, usually involving that one perfect spring or autumn night that occurs once a year, a romantically lit bridge, and sparkling lights on the water, and then say "ah, New York looks SOOOooo beautiful...like one of the prettiest cities in the world." and try to get through that without laughing.

Pretty much, that joke made me realize that it's not where I want to be. Even the people who criticized me for being so whiney about how SUCKY it was are now writing me and telling me they hate NYC and want to leave, and are in the same boat I am--how to apply to a new school/get references/give up the spot at Columbia...yadda yadda.

Bottom line is New York sucks. It's just a matter of spending enough time there to realize it. For me, that time was 4.3 seconds. For others, it's a couple months or years.

So I guess for now I have my answer. I'm going to stop thinking about Columbia, and New York, and if I blow my chance then so be it. If I end up too sick and disabled to do bedside care, and can't find the energy to return to school, then so be it.

Things happen for a reason, I suppose. I have to be in the now in order to stop being so miserable. I don't know if I can really DO this; this is just lip-service at this point--intellectualizing/verbalizing on here what it is I THINK will be the right answer.

I truely hate obsessing. So I'm going to set this down, and walk away from it, and hope that things work out.

Sigh...

2007-12-01T00:05:00.000-08:00

the hardest thing about this switching to night life is saying goodnight to my hubby and pooch as they sleepily head off to bed, and I know I have a long night of internet, baking, television (at low volume) and so on.

I think I'm blogging more because it's company...I dunno.

Mostly, I think I'm using it as a sounding board to see what it is I really think. Sometimes, I can't see the forest for the trees. Ironically, the word of the day is algorhithm. I've been thinking in algorithms lately. If this, then that. If I stay at this ICU and I return to New York, will I be ready? If no, return home. If I get an offer of a residency at UCSF and I take it, then I obligate myself to one year's service to them, then do I take it and sacrifice my place at Columbia? IF I do that, THEN do I reapply? Who will I get to write my reference letters? WHICH schools will I apply to? SHOULD I just change majors and do something I don't really want to do, but it's better than what I'm doing now? I could get 2/3 tuition reduction if I attend UCSF, but I can't see myself doing acute care NP or Cardiology NP...still, it's better than the fatigue of bedside care--that's killing me.

Sheesh.

This is what rolls around my brain like a marble.

surrounded by idiots

2007-11-29T15:55:00.000-08:00

I just called in sick to my unit. The nurse that answered the phone told the other nurse, who was precepting me for the first week I was there that I wasn't going to come in tonight.

"She needs to call the staffing office and the nursing supervisor"
I'm an orientee...I basically do the work at this point, while my preceptor sits at the nurses station and says "let me know if you need help" and then when I ask for some "you have to do that for yourself, you GOTTA LEARN..."

I told the nurse on the phone, "yeah, I was going to do that after I told you guys I wasn't going in. Hopefully, they'll find another orientee to cover for me."

Christ on ice skates! No brilliant thinker there.
This is what I work with.

oh, my head!

2007-11-29T12:18:00.000-08:00

Today, and yesterday, too, really, my head's been aching.
Right behind the eyeballs, sometimes behind the frontal sinuses.

Could be that I'm not sleeping right.
Could be a tumor.
Could be the heater dumping CO into the house (almost died of carbon monoxide poisoning once, in Minnesota) or it could be the lack of coffee since I'm not drinking it during the day, but after I wake up at night.

In any case, my head is killing me and I'm going to call in sick tonight. I have had two nights off in a row, and if I take tonight off, I'll effectively have a total of 4, or is it 5, nights off in a row.

I desperately need a break. This place is working me to the ground.

I went to class yesterday at UCSF (med surg emergencies) and it was interesting. During the break, I went up to talk to the Nurse Educator and mentioned to her that I was interested in their critical care training program, and that I'd missed it for summer despite applying in the first week of march. She gave me some people's names and told me to apply now, etc, and seemed excited about my education and my experience in an ICU. The drawback: if I go here, it will be in February, and I'd have to commit to one year of service to them. This puts me out of the running for Columbia, and forces me to REapply. Worse, this forces me to have to ask for reference letters. Right now, I can't imagine this; I'm the boob that doesn't know shit--what sort of reference letters would I get from my current employer? I shudder to think.

I got an email from someone at Columbia, in the CRNA program. She describes understanding what I was going through all last year, since she and her SO are now hating New York and want to leave, but if she leaves, she's in the same boat I am...having to find a new place, and reapply to new programs, so they're toughing it out for an unbearable 3 more years.

This matches the email I got from another gal, who went back home to San Diego, with hopes of applying at USC and a few other schools, but essentially said the same: how can I ask for references now, and how can I let my spot go?

it's a tough call.

If I go to UCSF, I could get 2/3 tuition paid by them to continue on in their NP program, but what would I do? I really wanted to do anesthesia...would acute care be a happy place for me? I don't think so, but it would be a far cry better than bedside care, which is wearing me the hell out.

Tired

2007-11-27T18:36:00.000-08:00

Tired, Tired.
and wanting so desperately to find a residency that will actually train me on some acute care. You know that type of thing I want: This means this...when a patient has labs that look like that it can be only one thing...that sort of thing.

I had an admission, AND a discharge last night.
4000 forms.

I learned a lot about paperwork.

When the shit hits the fan, and I'm on my own in a few weeks/month, I'm not going to know shit about shit. I wouldn't mind the paperwork if I were getting SOME, ANY, critical care stuff.

Ah, he's starting to crash? Hold on...I know just the form to fill out!

Grrrreat.

finally...

2007-11-24T15:12:00.000-08:00

came home this morning and konked out just before 9:00. I felt myself fading like I haven't done in a while--the knowledge that in T-60 I would be out like a light and nothing was going to wake me. I got myself between the sheets and sure enough, didn't wake until just before 3:00 PM.

My sleep has been so screwy, and my schedule for everything all topsy-turvy. I've decided to make 3:00 like my 7:00 am. Wake up, have an espresso, my Omega fatty acid supplements, make a late lunch for the hubby who's been tiptoe-ing around (and getting the dog to be quiet) all morning, and then the morning ablutions.

Finally, a schedule. Some regularity!

Last night I was in a deep, deep funk leading up to going to work. I worked with Wilma, a very nice Philipina in her 50s, maybe, but looking like she's in her mid 30s. She's quiet, and she's always tired, so I mostly let her pretend she was looking at the cardiac monitors while she dozed off, and did my thing on my own. Later she checked my paperwork.

I take the patient's flow sheets into their room, and write down their urine output for the hour, write down their vital signs, check them, turn them if need be, etc, and somehow this helped me stay on top of the charting. Ironically, both my patients last night were history of EtOH abuse, one with urosepsis and pancreatitis with a possible hx of un-dx DM.

So, the deep funk: I like Wilma and she managed to get me out of the funk because she always makes me smile. All day I had been thinking about how much I dislike this place...how I'm not learning anything remotely acute care, but rather their system for paperwork flow. This is a huge part of nursing, I'm aware, but I NEED a year's worth of acute care stuff. Columbia's Anesthesia program won't care if I know how to take off orders, or how to admit a patient, or discharge them. They are going to want to know if I can recognize someone who's about to head south fast, and what to do about it. (I don't.)

So, while my friends in NY have all JUST finished up 20 week residencies with classrooms and preceptors to ask questions to, I've just been learning where the linens are, who to call to page an orderly, where to take a body after patients die, etc.

Yesterday I came to the harsh realization that I've been miserable because of "Expectations." In the Buddhist sense attachment (to anything, ideas, hopes, expectations) breeds suffering and I sure have been doing that. I guess I was expecting I'd be picking up some stuff, learning some acute care stuff, when in fact they've overworked me to get me to learn to "prioritize and manage the load of two patients."

While they smile and say "let me know if you need help" they gladly refuse it to you when you ask and say "nope, you have to learn to do that for yourself." or if you ask them a question about a situation, med or pathophysiology, they say "Well, what do YOU THINK it is?"

Fucker...if I had the first inkling, or time to look shit up, wouldn't I do that before asking you?

Then the monster comes out of my head and I clamp down. I put my head down and work without asking anymore questions. I just try to make it thru my shift and my mind goes to its happy place: Back at Columbia, sitting in a classroom, in the anesthesia program with all this behind me.

Funny, eh? My happy place has become Columbia...yes, that's how bad it is NOW.

Ah, the snow, and crappy food...the lack of organization and bullshit. The good ol' days!

So, I came to the crap decision yesterday that no matter what, I have to find a new ICU placement. One with a residency, proper classroom setting, books, hand outs, organized curriculum...in short: UCSF.

Those nurses are on top of stuff. It's odd how during the first two classes, I was ahead of them as far as EKG and recognizing cardiac arhythmias, but during the hemodynamics class, a short month later (they had been continuously going to critical care classes, and I was returning for a second class) they were leaps and bounds ahead of me. Blew me out of the water with their quick answers when I was in the complete dark about what the lecturer was going on about.

But I know how to take off orders.

excellent.

So, I updated my resume, and I will see if I can get into the next training cycle at UCSF. When I quit this job, I'm going to go in and tell my nurse manager that I've found a critical care program that I want to attend. They had said they would look for a program for me to attend, but instead they've been sending me to these peicemeal courses hear and there which don't add up to the same thing.

She'll object, saying I need to run it by the education department and our boss will have to approve the spending and they've already spent X amount on my courses, while walking away from me, but I'll say "no...I'm resigning to go attend a critical care course offered by another hospital. Thanks for everything."

BWAH ha ha ha.

That's going to be awesome. I know this is petty, but it's pay back for all the shit they've been putting me through.

I will undoubtedly lose the ability to go back to Columbia...maybe. Becuase they won't understand what I was doing at this ICU for 6 months and if it was bad enough to leave, why should they count it? OR I will have to obligate myself to a year's service and then won't be able to return to New York and lose my spot.

Then it comes to why I was in a funk: If I lose my spot, I have to reapply to all sorts of schools all across the nation. I have to RE-ask everyone for letters of reference. Think on that one--I'll have how much experience? and have to ask people "hey, as a new nurse, would you recommend me for this?"

That in itself is going to take a few years.
And my health will probably deteriorate to the point where I can't endure school anymore, the hours, the sleep deprivation...what in my 50s?

So the funk comes from being trapped midway, in a place I hadn't even intended for more than a year for myself. My fate's been decided for me in a place I never wanted to be.

Originally, I was going to go for my NP in Acute care. At least, with MS, I could be an Acute Care NP. I would do some bedside assessment, go back, write a few things in the chart, and leave. This job is so god damned physical that it was a crap shoot I'd be able to do it for even a year.

I'm spent.

So, there is the funk for you. Imagine if you had come to the realization that you're probably going to be trapped indefinitely at a job you never picked, on your way to another job you WERE hoping for.

We'll see what UCSF says. At the very worst, I'll reapply to UCSF and go back to the idea of Acute care NP. I've heard it's easier to get into UCSF once you have a BSN.

that's all I have to say about that.
Be well, peeps.

I think I see your problem, here...you have no brain.

Wahhh!!!

2007-11-23T00:31:00.000-08:00

I just want to go to bed now and yet this is when I have to stay up. So, I'll tell you about the baking I did earlier tonight. I made my super good oatmeal cookies that I always make (I'll share the recipe with ya, in case you want to make them) and I made a pretty decent carrot cake with the pulp from my juicer.

I've been using the Champion Juicer with more regularity. As with all juicers, the clean up is what makes you not pull it out of the cupboard, but I am getting used to it so it goes faster each day.

It's great to be able to get all the vitamins from all 5 or 6 veggie and fruit servings in one glass, without filling up. I juiced 4 carrots, a pear and a plum. If I had to eat those, I'd be so full it would pretty much take me all day to eat them, and I wouldn't be able to eat anything else. I'm the first person to advocate eating LOTS of veggies and fruits for the fiber, but I'm losing weight steadily, and at my height, I'm starting to look like I have an eating disorder...I think the people I work with think I have issues, anyway. They're very concerned with what I eat and when and how much, but they all outweigh me by several, several pounds.

Anyway, I always hate throwing out the pulp, and I was pleased to see the Jack Lalane juicer comes with a recipe book for creatively using the pulp.

SO--here goes; my take on carrot cake. Adapted from How to Cook Everything by Mark Bittman...it's one of the most used books in my kitchen.

1 & 1/4 cups whole wheat flour
1 & 1/4 cups all purpose flour
1/2 cup cornmeal
1 tablespoon baking powder
1/2 teaspoon salt
3/4 cup sugar
2 eggs
1/4 cup (half stick) melted butter
1 & 1/3 cups milk
1 cup grated carrot (mixed with fruit pulp is good, too)
1/2 teaspoon vanilla extract
1/2 teaspoon ground cinnamon

mix dry ingredients together, mix wet ingredients together in separate bowl, combine by making a well in the dry ingredients and add wet ingredients. Mix until well blended. Pour into a greased 5x9 loaf pan and bake in a preheated oven at 350 degrees for about an hour+15 or 20 minutes.

tastes a bit more like corn bread, than an overly sweet carrot cake. I really like it and will make it again.

Now here's those cookies. Every time I make these they're very popular and I must have given the recipe away a dozen times now.

1 stick (8 tablespoons) butter, softened
1/2 cup sugar
1/2 cup brown sugar
2 eggs, room temp
1 cup whole wheat flour
1/2 cup all purpose flour
2 cups rolled oats
1/2 teaspoon ground cinnamon
pinch of salt
2 teaspoons baking powder
1/2 cup milk
1/2 teaspoon vanilla extract
Then, I add a couple of fists full of either raisins, or milk chocolate chips, tonight I made them with bittersweet chocolate chips and a bit of chopped pecans.

in a large bowl, mix the flour with the softened butter, into a crumbly meal. When it's well blended, add the rest of the dry ingredients and mix well with a fork. Slowly add the wet ingredients, and mix. Bake on a cookie sheet in an oven preheated to 375 degrees for about half an hour or just until the edges start to turn golden brown. The book says 15 minutes, but in my oven, they're still wet at this time.

and that's all I have to say for tonight I guess. (sigh)

Hope you enjoy these recipes!

nights off

2007-11-22T02:33:00.000-08:00

well, the nights on are not a problem...staying awake, I mean. I think for my first night I had been on about 4 hours sleep total for the entire three days leading up to that night, and last night, I managed to get about 4 or 5 hours of sleep.

I mean yesterday.

Or, the day before yesterday. I'm not sure. That's one downfall of this night stuff--you never have the same point of reference as other people do...for most of us, our sleep cycle separates the days. You wake up and it's a new day. For people who work nights, the new day starts at midnight and ends, who knows when...when you go home and fall asleep, you wake up and it's still the same day. You take a quick nap before going to work that night and it's still the same day! How can it be that I go to work twice in one frigging day!?

When do I take my vitamins, brush my teeth, bathe, shop for food, etc? It's not the same as when you sleep nights and walk the earth by day. There's a definite "time" to do things that gets all out of whack when you reverse sleep patterns like this.

In any case, I think my first career choice prepared me well for sleep-deprivation. If sleep were water, I'd be a camel.

Another downside is that one must adjust to activities allowable during nocturnal hours. I had all these great ideas about baking (this has the two-fold benefit of warming up the house, because we usually turn the heater off at night, and filling the pantry with yummy baked things.) I was envisioning myself studying while waiting for scones and bread to come out of the oven. Or cleaning out my study and organizing my bookshelves, the closets, sewing and knitting...

As if.

I tiptoe around the house so as to not wake the hubby and dog, still on diurnal schedules.I'm sure I'm being overly careful. He keeps telling me I don't have to be so quiet, but I don't want to wake him. All my kitchen cabinets squeak like mad and I'm sure, wake the elderly neighbors next door to our common wall house every time I open them.

So, so far...my first night off has consisted of realizing that I need every gadget sold on infomercial prime time.

Is it that when we are laying awake, insomnia-stricken, our judgement is impaired and we really want that Magic Bullet to mix up omlettes and muffin mix and then grind coffee beans and make guacamole and salsa all in under 10 seconds? Am I supposed to overlook the fact that all the food has been prepped, chopped for them, or is sized to fit perfectly already? Why don't they count this prep time in the total time it takes to make their food? I can't wash and rinse, chop and prep all my veggies as they did and THEN use the blender. I also don't have 400 of them, so I'd have to stop and wash it between menu items. Did you get a little egg in your mochacino? So sorry.

Another sucky thing: I've watched more television in this last week than I have since I've been home from New York. Well, ok, maybe that's a bit of an exaggeration, but it FEELS that way. I don't like the tv, but I find that I'm watching it for company, and what's worse--my standards have dropped significantly.

I'm actually watching some idiotic Brendan Frasier movie (really bizarre!) and enjoying it--I have to find out what the name of this movie is and rent it to get the beginning of the story. It seems to be a sort of Tim Burtonesque craziness, or something.

I appologize for the prattling on...what the hell is a blog if not self-indulgent babble? I'm trying to not make it sound like the monologues of Sex and the City, but I'm not sure it's working.

So, with that, I will leave you, my friends, for tonight.
Happy Thanksgiving/gobble-gobble/slaughter of the indigenous day. Whichever you observe.

Me? I'm planning on sleeping through most of it.
That would be tomorrow, right?
Or later today...Ah, I don't know.

(PS--I just googled "brendan frasier monkey" and found out the name of this movie. It's called "Monkey Bone" and was evidently harshly reviewed (D+) by most online reviews I saw. It's hilarious, though...I guess the reviewers were nocturnal sleepers and failed to see the brilliance of it all)

Check it out

HAHA!

(Don't they use sleep deprivation as a form of torture, to break your will and brainwash you or make you susceptible to suggestion? Hmmmmm...perhaps this is why 3 am is prime infomercial time.)

already loving nights

2007-11-20T16:15:00.000-08:00

Well, after trying to switch my sleep over to days and life to nights (unsuccessfully!) I went off to work last night at 11 pm and was surprised that I wasn't the least bit tired and the night flew by.

I was lucky in that the patient census is down, so I only got one patient. I was upset that Marie, my preceptor, informed me that I'd have to take the admission if there was one, but from her facial expression, she gave me that it wasn't her decision, that that came from higher sources and that she felt bad about it.

I told her I was feeling like "higher sources" were trying to pressure me to quit by treating me this way, which she denied--I told her I didn't feel I was actually learning anything "acute care" but rather How to juggle paperwork for two patients all day long.

The night crew, as everyone told me, was way cooler, way more mellow, way friendlier, and super awesome. The other orientee, Andrea (a former traveler nurse with 2 years ER experience) was also there and she was very supportive and offered lots of advice. The other nurses were keen on planning thanksgiving eve dinner together, a potluck, and then a celebratory going out together to celebrate my and Andrea's arrival to nights. How cool is that? The other nurses on days purposely excluded me from conversations when I tried to join in. "oh, is that your new place?" I'd ask with interest as one of them was showing another pictures of a living room on the computer.

"No."
(silence)
and then back to talking to the other nurse about the pictures.

Not, "no, this is a place i'm thinking of buying..." or "No, this is a picture a contractor sent me of his work because I'm thinking of hiring him." Nothing but 'get the fuck out of this conversation.'

The night crew was full of opinions about the day staff and all I could do is smile and say "ya know...I....I can't talk bad about people"

But they knew I knew whom they were talking about, or what they were saying.

The day staff came on at 7 and didn't say hello. I left for the day and wished them all a good day and the only person to answer was one of the night staff that still remained.

Good ridance, bitches. Take your strangeness and be gone.
Nights rock.
Now all I have to worry about are the codes.

I'm a guy's gal...

2007-11-17T10:28:00.000-08:00

I always have been.

My older brother was my hero when I was a kid, and I pretty much grew up trying to please and impress him. At the age of five, he had taught me the names of all the tools he used when working on his car, so I like a surgical nurse, would sit on the sidelines next to his tool box and wait for him, under the car, laying on a scrap of cardboard or a carpet remnant, to say "five eighths combination..." holding out his hand, expecting a 5/8ths combination wrench to be placed there.

I remember that teaching me the fractions was the hardest part for him, and nearly where he gave up on me. Did I mention I was about FIVE?

Through my adolescence, there was only one really close GIRL friend, and we were like twins--went everywhere together, dressed alike...we even had our own language that we had made up--hillarious.

We eventually grew up and apart as is common, but it was mostly a major rift between us that stemmed over lies and lying that tore our nearly lifelong friendship apart. I can't forgive ethical and moral flaws. Flaws are one thing...to find out things about someone's moral fiber that deeply goes against yours is sometimes too much.

Having spent so much of my life surrounded by male things--cars, sports, and so on, I've not been encultured properly to the world of women. I even chose a very male-dominated profession which I hadn't realized, was pretty hassle-free and laid back for the most part.

Nursing, for the most part, is still a very female dominated profession. While I do work with a few men, and find that it's easier to interact with them, largely I find I'm spending most of my time trying to decipher what the hell things mean when they are said the way they are.

I got into trouble the other day when my preceptor said "we need to call Dr. S and ask her _____." OK, I thought. :| right?

Think about that comment coming from a guy: "We need to ______." It means absolutely NOTHING. It's a statement like "the sky is blue" or "the cat is in the yard." This is a form of PASSIVE speech which doesn't effectively communicate to the listener anything. It's great for prose, and fiction (again--stupid paperback books women spend endless hours reading...what is the POINT of fiction writing for crying out loud?! You might as well be wasting your time in front of the televion, while you're at it!)

But, I digress.

Passive speech: "We need to do this and that."
Active speech: "Call Dr. So-and-So and tell her this and that." THAT would have at least conveyed to me that it was an expectation for me to handle this task. At the end of the day it was "did you call Dr. So and so to tell her____?"

"Uh, No, I thought you were going to do that." What I really wanted to say is "What's this 'WE' shit...what are you, Queen Elizabeth?" But I didn't.

A militant lesbian I once worked with pointed out how women almost always speak passively, and that she liked that I didn't do this. "You ever notice that women will talk AROUND what they really want, rather than just coming out and SAYING what they want? They will say 'It's cold in here' when what they really mean is 'Shut the window.' Why is that? Why?"

When I had to write papers for AFROTC, we were severely marked down for using a passive voice EVER. The simplest thing was analysed. The book is on the desk. Period...not "the desk, upon which the book had been placed..."

Men are more direct. Men speak actively. "Get the fuck out of my way" not "I can't see the television" or "you make a better door than a window..."

I need a woman to English dictionary. Perhaps I need to write it. "We need to..." translates as a direct order. Come to think of it, the mafia uses indirect speech to communicate. This eliminates blame on anyone giving an order. "That guy makes a lot of noise" might translate to "kill that bastard before he talks too much."

Come to think of it, women are like a mafia. One is definitely either in or out, and I'm always on the out. But, I'd rather be. My life is much happier without being part of the whisper pow-wows that take place in corners of the nurses' station, about he said/she said, he did/she did, or any OTHER type of unneccessary BS. "Who gives a RAT'S ASS?!" I keep wanting to say when I hear anything like this...If you only knew how much time out of a womman's life is wasted on talking shit that does NOT MATTER in any way...life is too short to be spending my time watching "Desperate Housewives" or "Grey's Anatomy", then talking about it all the next day as if they're real people (UGH!) or reading fiction, or talking shit about other people behind their backs.

In short, the few women that I've come to be close friends with over the years (my mom especially) are NOTHING like the archetypal woman; I really hate women, usually. I don't understand them, don't like their company, don't love working with them for the most part. The thing I'm starting to realize is how rare it is to find a female who does not belong to this she-wolf pack of catty, vicious beasts.

Working with these types has certainly made me appreciate my female friends as being exceptions to the catty woman norm, and I salute them for being bigger and better than that, for talking about more than television, or fiction novels, or other people behind their backs (ah, my preceptor was also busted talking shit about one of the female docs, whom I think is great, but they hate her, inside our locker area when the doc had come in to the lounge to have lunch, and was on the other side of the door hearing what they really thought of her...how embarrassing--you think this would cure her of ever talking shit behind someone's back? It would cure me, but she probably got over it quickly.)

I'm selling out the sisterhood here, I've been told. Fuck the sisterhood.
Bros before Hoes, I say.

November mornings...

2007-11-12T21:38:00.000-08:00

I was musing on the way to work today that I'm going to miss the crisp November mornings. The light has been amazing these past couple of days...the sky an indescribable shade of blue, the clouds black and pink, the trees are red and dropping their leaves--in Italian, we'd say "Mozzafiatto" (a breath flattener, or breathtaking, I guess. I like flattener of breath better.)

I have only two more day shifts to work before switching to nights, and though part of me is anxious to get away from the strange games women play (I think the night crew is a bit more laid back) I am going to greatly miss daylight.

The mediterranean is in my DNA, for crissakes...how am I to live without the sunshine?!

Those of you who know me know me well enough to understand this: I have a plan.

I plan to use the nights when I'm off to study for going back to school. I will pour over acute care/critical care books and get really really comfortable (hopefully) with the physiology of acute care.

It really bums me out to have been taking care of a very good looking young man (44) who was recovering from a surgery, and then coded, only to be lying in a vegitative state for the last week or so...it's so damned sad. ugh--I can see how this can happen to anyone, and I try to treat every one of my patients with the dignity, care and respect that I would want to be treated with, and what's more, that I would want anyone I care about to be treated with. I can see my own end, someday, lying in a vegitative state in a random hospital bed, full of bed sores, unable to move under my own power, no one giving two fucks about me being there, the nurses saying "doesn't she have any family?" and so forth. It's a damned shame how most of us come to an end, it is.

In short, it's depressing this job. Every day I wonder how people can do this for years and years. We develop a macabre sense of humor, to be sure, and we develop a sense that our time is numbered. We too shall walk down this path to the end of our own personal trails...

I guess I am looking forward to going back to school. In fact, I don't want to let the opportunity go by me and give up my spot at Columbia to risk not getting into another program. Screw it, I'll just suck it up and go back next year and be done asap.

Tomorrow I'm going to hang the thick dark purple (almost black) curtains I got for the downstairs bedroom, where we have to relocate to. It kinda creeps me out a bit to go back down there to sleep...that's my old bedroom, the one I slept in as a teenager, the one I snuck in and out of in the middle of the night, the one G and I moved back into when my mom grew very sick toward the end of her life...I can almost hear her padding around lightly upstairs, back and forth to the bathroom at night. That's going to be hard. I'm almost afraid I'll dream she cracks the door open and says something to me the way she used to. After she died, we moved upstiars and changed everyhing around. Her room became my study, lined with bookshelves, and my drafting table, and desk...and her sewing machine. The room I slept in as a baby is now my bedroom, but it gets WAY too much light for a day sleeper, so back downstairs I go.

Where's Anne Rice when I need her? This sort of thing would have appealed to me when I was about 21 years old...but at twice that age, I only dread the idea of day sleeping.

I have found a gorgeous (but expensive) pool for a morning swim, after my hectic shifts, and then I'll come home, walk the pooch, and settle in for a sleep.

I'm going to start collecting pictures of sunny beaches to put on my desktop at work--just to remind me. A terrace in Tuscany, with the orange glow glinting off the terra cotta tiles of neighboring roofs, the swaying palm on a white sand beach of some tropical island...it's only temporary, I tell myself. And everyone has had to do it. It's not the end of the world.

Still, my biggest fear is dying suddenly without having a chance to ever see the sun again. New York is 10 months away. Miles to go before I sleep and all that sort of stuff. PS--how do the Nordics handle this long dark winter crap?!

Enjoy the light, my friends.
:)

my days

2007-11-01T19:09:00.001-07:00

Pretty much, I have been taking care of two patients now on my own for about a week. The hard thing is that this place is still paper charting. I can't stand the paper charting!

Admitting a patient from the ED takes forEVER! There must be 40 forms and shit that get all compiled and cross referenced, filled out in triplicate and sent off to different places...ARGH!

On top of the hourly ins and outs, and vital signs, etc.

I'm actually thinking for most of the day "it's only for another 9 or 10 months...then it's back to School.

I go on nights in two weeks...not looking forward to THAT, either!

The nice thing is how every single one of us at the ETP anesthesia program have stayed in contact and pretty much all the same shit I'm saying is the exact same stuff they're saying. They treat me like crap, I feel like an idiot...yadda yadda.

Nice to know I'm not alone.

So far, my patients are doing great, their meds are on time and no screw ups there...but that paperwork...oy vey GEVALT!

How it's going so far

2007-10-22T18:05:00.000-07:00

Meh.
As predicted, I'm not loving bedside care. On the one hand, it's very challenging and here's all sorts of cool stuff to learn. On the other, the patients are for the most part, sedated, and will never know you are there (it's a bit thankless in that sense.)

I went in this morning to my assigned patient's room, and closed the blinds as the sun was just coming up over the horizon. I noticed a dead sparrow on the ledge outside the giant picture windows. Poor thing must have flown into it and it was over quickly.

The irony was not lost on me. Dead sparrow on the ledge, half dead people inside. "Good morning Ms. S, I'm Lisa...I'll be your nurse today. It's October 22nd, Monday morning, and it looks like it's going to be a beautiful day outside today..."

I look at the sedated figure before me, breathing on a ventilator, a minimum of half a dozen IV drips going.

Yes, indeed...a beautiful day, Ms. S.

I'm counting the days until I can go back to school and get out of bedside care. it's alright, when they're awake. I guess if I had my choice, I'd go back to the CCU where at least some, if not most, of the patients are awake.

The biggest lesson I've learned: Stay out of hospitals.
And get your advanced directives in order.

just when you thought it was safe...

2007-09-27T20:55:00.000-07:00

I'm starting to look at anesthesia programs in the area.

So far, I've come to the conclusion that I'm not going to get in anywhere. Applications are due either in November or January and either way, I'll have (still) zero experience so who would accept me?

Kaiser Fullerton's program requires a minimum of two years in the ICU and so does SUNY (not that I wanted to go back to New York, but at least Brooklyn is tollerable)

Ay caramba. It's looking like next year will either find me going back to NYC or giving up on the whole thing altogether. I'm not the sort that likes those odds (of hanging around and waiting to get into a different program) because there's no guarantee I'll get in anywhere, for years. So, by the time I'd be even slightly competative, I could have just been done with the whole program at Columbia.

This whole thought depresses me.

Then, I wake up and find an email from the director of the anesthesia program at Columbia, mistakenly, somehow CCed me along with the group of people she was emailing about some accreditation bullshit...could it get any more pathetic over there?

So, now, a sort of count down begins in which I worry about having to leave again, my elderly dog's advanced age and me not being here if something happens to him, about the miserable weather there, and not having a car, and how rotten and fatiguing it is for me to ride the subay...

Either I give up, or I resign myself to this.

I'd love to apply somewhere else, but I'd have to re-write my essay, ask for more letters of reference, and holy hell...is it worth all that? It's excruciating to go through the application prossess (not to mention, it costs an average of a hundred bucks per application)

This sucks.

I just don't see myself in the ICU for years and years. It's interesting, but I really don't love bedside care and find a lot of stuff that bugs me about patient care. I hate watching people wither away on ventilators, or going in to find that my patient of last week has coded and died on my day off...

I can't see myself doing this for more than a year or two max.

So...how was YOUR day?

2007-09-11T17:21:00.001-07:00

It was a fat lot better than it was for Mr. K, I can tell you that much with certainty.

This morning, day number two in the ICU, I was told to follow Angel, the EKG tech and assist him and do the EKGs. It turns out Angel's supervisor and one co-worker had called in sick so he was swamped with stuff to do, so he wanted to fly thru those EKGs as quickly as possible (explaining stuff to me was slowing him down, though I tried to help him and speed things up.)

We did 4 EKGs (truely ECGs) in about 10 minutes down in the regular med-surg floor.

The last one we did was Mr. K, whom I thought looked pretty good for someone requiring an ECG. He was thin, about 60 y.o. and awake and oriented times three.

Ten minutes after I returned to the ICU they announced a code blue over the hospital PA system. My preceptor/nurse manager sent me down to observe a code. No problem, I've seen a couple of those.

I arrived at the blue light on the med surg floor to find it was Mr. K. with 15 or so people in his room, his room mate now gone, and a big orderly doing compressions on him. The anesthesiologist kept looking at me in the corner, asking for this and that, and I'd leave the room and ask a nurse on the unit for whatever he'd asked "they're asking for --- in there and I'm not on this floor, sorry"

Here's the kicker--this code, I shit you not, went on for two hours. Yes...CPR for two hours. This cardiologist would not let go.

The nurses were looking at each other and shaking their heads "what's left of that brain, even if you do get a normal sinus rhythm?" they said. The anesthesiologist got them to transfer the patient to the ICU so he'd die there, or so he could start a central line...it's still being debated.

At 10:42, they finally gave up, and called it, and the nurse I've been watching for two days said "go get his wife."

As you can imagine, she was a mess. 41 years of marriage, and her best friend, she told me, not just her husband, was now gone.

"I've never seen them work so hard to try to revive someone" I told her, in an effort to help her feel like there was nothing else that could have been done.

Truely, when your number is up, it's up.
So, today I got to learn all the things you get to do when someone dies on your unit, including transporting the cadaver to the morgue, and putting him in the icebox next to the other cadavers in body bags. The smell was nothing like the cadaver lab in gross anatomy. My preceptor was telling me "now, on nights, when this happens, you'll have to call security to come and open the morgue because there's no one here afterhours" and I wondered what it would be like creeping into that cold room with all the cadavers in their silent vigil at the wee small hours.

Ah, I don't know what I'm rambling on about.
It's just another day.

I guess what slapped me in the face was the thought (all the way home) "did I smile at Mr. K and was I as nice to him as I could have been? or was I wrapped up in trying to learn this ecg thing..." I was one of the last people to see him alive--what a heavy thing.

I could have touched his hand and been more compassionate.
There's always room for more compassion, damnit.
I could have taken an extra 30 seconds to smile and say something more to him before leaving his room.

I don't know why this is bothering me so much.
His daughter and mother wanted to know everything he had said and done leading up to the MI. All I could do is tell them what I'd seen, and that it was very quick, and he didn't suffer (hah--a massive MI must feel like your heart exploding--but they were suffering enough.)

I wish I'd taken his hand and smiled at him.

I PASSED!

2007-08-12T19:52:00.000-07:00

wOOt!

I can't believe it!
I just got home from four day's camping (Richardson Grove and Sinkyone...I'll blog about that tomorrow) and I just checked rn.ca.gov and I'm listed as an RN!!

Isn't THAT scary!

Dead man walking...

2007-08-08T21:46:00.000-07:00

Oh holy hell, that was like...the HARDEST test I've ever taken in my LIFE!!

The first twelve questions kicked my ass.

Then it got harder.

They tell you going in that you could get 75 and then it shuts off, meaning you've done enough for the computer to evaluate if you've passed or not passed.

Mine went past 75 (meaning it wasn't sure) and stopped around 90.

I have one friend that told me theirs went to 120 and got a passing grade. Though they tell you there are up to 265 questions, you have no idea how many you're going to get.

It was unbelievable.
The security was crazy too...you'd think the president was going to be sleeping in that room with you and a box of loaded revolvers. I must have had my finger print scanned 20 times, my picture matched to my id (yes, they take their own picture)

Crazy.
I hope I Passed because if I have to go through that again...I just don't know.
I'm going camping for a few days, while waiting for the results...

I'll let ya know how I did.
(pray for me, pray really hard!)

Ich Habe Jetz eine JOB!

2007-07-27T09:33:00.000-07:00

Woo hoooo

Ok, so, I've been hired at the San Mateo County General Hospital ICU.

The pay is pretty good, the benefits are outstanding, the hours will suck (nights) but I will be one-on-one with a preceptor teaching me in the ICU rather than go thru a residency program and then have to get selected for, or work my way up to an ICU.

I'm pretty shocked it was my first interview, even. I've not gotten this far with the application process; most places seem to just want to get your resume and contact info for the next time there will be a shortage. They tell you they don't currently have any positions, and they don't hire new grads for the ICU. But they might have a residency training program starting in October, if they choose to do it, but they only hire for the ICU from within as those spots are first offered up to internal applicants...but not to lie and say you want something other than what you really want, just to get in the door, because they'll be able to tell if you're lying...

Whatever.

So now I have to pass the NCLEX, go get fingerprinted, blood titres, have a physical, immunizations, etc.

I will be oriented and trained during the day shift, but the only position available is nights. The nice thing is that the average tenure for the nurses here is very long (6, 10 and 15 years) and it's a brand new addition to the hospital so it's completely state of the art.

It's not a CCU but I think the mixture of patients will be good, and I think also being a bit smaller will work out to my advantage as there will be more time to ask questions, and do things myself, rather than have so many people around to just do them and tell me they'll show me or explain later.

I'm pretty happy.
And relieved.
This was getting crazy stressful and the job market was proving to be a huge disappointment. I'm glad it's over (barring any unforseen "something" happening, you never know)

I finally have a job.
I haven't been gainfully employed (besides tutoring) since 2002!
I've got more than a few bills to pay down now :P

What I did yesterday

2007-07-25T08:13:00.000-07:00

Drove around again.

I went down to the Santa Clara Kaiser info session. It wasn't posted on the Kaiser website, but on Aftercollege.com. I didn't get any new info, other than they don't take new grads into the ICU (nevermind that their website is openly advertising for such, and the paper they just handed you says NEW GRAD TRAINING and one of the departments listed is the ICU.

While I was still there, before the info session started, I placed a call to Steve, the recruiter for San Mateo County. Their website says they have ICU nurse positions and that they do train new grads (I've heard this before, and it's a lie)

So, he called me back, and I was quick to lock down a meeting with him as soon as possible. He was openly recruiting and selling me saying that once I saw the hospital and met the nurse manager/educator, I'd be hooked.

So, I went down there and met him, he toured the entire hospital and I have to say, it's nicer than CPMC. I had no ida a county hospital could be so nice.

They've got by far the best pay and benefits I've seen, and although it's a small ICU and I'd be on nights, I'm confident they would be willing to teach me everything.
They even want the ICU nurses to get certified in Chemo, and Peds and all sorts of things, so...hey, if you're willing to train me, that's just more stuff for my resume, go right ahead!

They scheduled me for an appointment Thursday to come back down and meet with my preceptor/Nurse manager and according to the recruiter, if she likes me enough, she'll tell him to pull off the ad and they'll wait for me to pass my NCLEX.

I've got high hopes for this one.

Also, I got a call back from the CVICU director at SF Kaiser, who was one of the people I gave my resume to...she sounded impressed with my resume and said twice in one phone message that she is eager to talk to me about a position.

So, things are looking slightly up.
I don't want to get my hopes up, because as has happened in the recent past, things don't always pan out with these folks.

I'll keep you posted!

Still no job

2007-07-23T21:07:00.001-07:00

I have applied to around a hundred jobs since May.
If you count back to March, when I was applying from my 8x10 foot room at the Columbia dorms, maybe 150.

I still have nothing.

I'm exhausted. Today I went to Kaiser SF to sit through their info session and listen to why I want to work there, along with every other newbie nurse, some of whom have their RN already, some of whom are already nurses, some of whom decided to show up in jeans.

I then went to UCSF to try to get into the OCTOBER new nurse training residency, and then went to SF General, where I walked about 15 blocks trying to find the damn building after the jerk inside kept sending me to 25th street to HR after I told him I was looking for 1001 Potrero street.

Tomorrow, I drive down to Santa Clara for their info session, where I get to listen to the same stuff, watch the same slide show, collect the same packets, etc.

I'm so tired, I could cry.
I'm getting ready to just give the fuck up.
I guess there's a glut of nursing students that have just graduated, no jobs, and no one, but absolutely NO ONE wants to train a new grad for the ICU.

Thanks Columbia university ETP program...I'm so happy I went all the way to New York to attend. Jobs in ICUs are infact a breeze to get, just like you said.

after talking to the wise one...

2007-07-18T08:06:00.000-07:00

I came to a better understanding of my situation.

I've been told there's one residency, at night, in the South SF Kaiser, and then I have an interview at the Mills-Peninsula ICU next Friday.

Check this out: Mills-Peninsula expects you to drive to Fairfield a couple times per week ("oh, you can carpool") to take their didactic classes, and then they expect you to PAY FOR YOUR TRAINING with the promise of reimbursing you upon hire.

Hahahah, I don't think so.

Afterall, I already have a spot in the ICU residency at Kaiser SSF, it's also nights but it's 5 minutes from my house, I don't have to pay for my training, and I don't have to drive to Fairfield, and oh yeah...it's KAISER! One of the strongest and biggest hospital organizations around. Plus, the wise one told me that if I go off to anesthesia school and come back to Kaiser, I won't lose my seniority, but pick up where I left off.

Nice!

Oh, and did I mention that Kaiser has one of the three schools in California that offers anesthesia MSN?

I'm not sure I'll be able to not laugh at the people during my interview at Mills...seriously, what do they think they're doing? How do they expect to get good nurses, let alone keep them?

I'm just keeping my fingers crossed that everything goes well with this Kaiser residency. I'm going to have to keep my fingers crossed that I pass the NCLEX and the training goes well, and they like me enouogh to offer me a position...and that I can handle working nights :(

Ahhh, the struggle.
Would I have started all of this had I known? I don't know...probably, but who knows?

oh holy hell

2007-07-17T12:09:00.000-07:00

I'm so sick to death of all this crap, already.

I'm done with the Kaplan review, and I think my scores went up slightly, but I'm still only marginally passing according to them.

I've scheduled to take the test, which is funny.

When you sign up, there's a calander and I was stupidly thinking..oh, I'll take it next week, toward the end of the week. HAH. Every test day is taken and full!

I was hoping to take it friday or saturday (the 27th, or 28th) so I was looking into what those days mean, in numerology (getting stupid and supersticious for a moment)

According to one source, 9 stands for Completion which I thought "hell ya, complete this and get on with my life, already!" but 10 means Rebirth. I was thinking Rebirth is probably more apropos: like a phoenix arising thru the ashes of a destroyed architecture career, rebirth might work out well.

But, sadly, the San Fran testing site seems to be booked out until September some time (crap!) so I had to change to the Oakland site.

I was lucky enough to snag a day of personal significance, August 8th.

8 has always been my lucky number, or rather my favorite number. I always wanted to make a soap-box racer with my brother and we had decided on 88 as our number because if it flipped over, it's still 88

Silly? :)

Ok, how's this: I had my first date with my hubby on August 8th, 1988.

We consider that a more important anniversary than our actual wedding. We love that this accentally happened on this day...neither of us knew until the following day.

So, For now, I'm scheduled on Augst 8th, and this works for my supersticious side because the number 8 (八 in Chinese) stands for sudden fortune, prosperity. Which would certainly be true, if I pass.

So, on the 8th, wish me some luck, send me your smarty pants vibes, and in general, keep your fingers crossed for me

All 8 of them :)

updates... not much news here

2007-07-12T21:33:00.000-07:00

God Almighty.

I thought I had two residencies lined up, but so far, one of them has turned sort of flakey, and the other seemed to let me slip thru the cracks (maybe they're not interested?)

I just finished the Kaplan review and though my scores were better on the exit exam than the diagnostic exam I took on entry...I'm still only "marginally" passing (not a nice, safe, slam dunk, if you ask me)

So.

I've managed to get the eye of two ICUs--one in South San Francisco, and another one in Santa Clara. The problem is two-fold: it's NIGHTS and the other is that Kaiser hospital seems to not give you an ICU placement without lumping in the Step-down obligation...so...I have to do step down in order to get to the ICU. Cross training I think they call it.

All this means to me is that I will get minimal time in the ICU as long as they can ship me off to the step down during a shortage.

WTF?

Anyway, I'm pretty unhappy these days.
I'm not ready for the NCLEX, I have no job...etc.

oh well.
That's what's up here and why no updates.
not much to tell.

Oh the humanity, what a day!

2007-06-25T20:12:00.000-07:00

Terrible day.

After trying to get somewhere on the phone with the California Board of Registered Nurses, I grabbed my transcripts and packed a snack and off we all went to try to see if we could get somewhere in person. George came home from work, we packed the dog up, and took off for Sacramento.

We arrived in just around 1.5 hours, there was not much traffic. Within 15 minutes or so, the very same woman whom had sent me the letter was looking at my transcripts and saying I had a class on there that would count (Anthropology...roughly 14 or 15 years ago) so she'd process my application within a day and that I'd have my interim permit by Wednesday. (can it be? am I dreaming?)

Then, you'd think it was a nice, happy ride home, but as we drove home, I tried to contact the person that called me to tell me they had a new nurse training program starting August first at the Kaiser near my house (South San Fran) and am I still interested?

YES, YES, GOD...YES!

But I couldn't get her on the phone...no voice mail either.

So taking George's "don't take no for an answer" attitude, I decided to run in to the house, change clothes, and run over to that Kaiser. In person seemed to be workin for me so far, today...why not keep pushing my luck?

It was 4:30 pm when we got there and the blue-haired volunteers didn't know what I was talking about. But luckily, there was a paper on their desk that said "Human Resources" with an address and phone number. Once again, I learned as I was getting nowhere with the phone call, that going there was the only way to solve this.

With George driving, (thank god, because I'd have gotten lost about 4 times) we got there with 10 minutes to spare before the office closed.

"she's already left for the day" the receptionist said.
"can I leave her a note and my resume?" I asked "she called me this morning and I had told her there was a problem with my licence, but I drove all the way up to Sacramento to clear it up, and I'll have my permit on wednesday...if the spot is still open, I'd love to be considered for it"

She was so nice, and told me she'd make sure she got my note and resume.

How cool is that?
on the way home, I screamed out the car window, driving over the desolate mountain pass "I DON'T TAKE SHIT FROM NOOOOO ONNNNNNE!"

let's hope this is a new year for me; one in which I can overcome all my obstacles.

Thanks for your kind support, and prayers, you guys.
I love you :)

That's it, I'm cursed.

2007-06-25T09:36:00.000-07:00

You are not going to believe the latest news on the "become a licenced RN" front.

I got a letter from the CA board of nursing that states Columbia transcripts don't reflect sociology and psychology courses. Well, this doesn't suprise me since I haven't taken those courses there.

So, my application didn't say anywhere I needed to prove courses as prerequisites; I figured that since I have a BSN that they'd just KNOW that I did those things...but oh...not so.

So, after being on hold and treated rudely all morning, I've found out that If I can get them transcripts that show these courses, I might hear back from them as soon as FIVE WEEKS from when they RECEIVE THE TRANSCRIPTS.

This might not sound so bad to you...but add to this the fact that I need to request transcripts from my other campus to be sent, for them to process them...and Oh yeah...I HAVE NEVER TAKEN SOCIOLOGY.

So now, the mad scramble to find a sociology course in the summer, that hasn't already started, that won't end in december, that isn't 400 miles away.

I've pretty much lost my spot in the Columbia anesthesia program, I have lost my residency at Kaiser which starts in August...

I'm fucked is the short answer.

Good News!

2007-06-16T22:48:00.001-07:00

The people at the Kaplan center put in the wrong code, so I did much much better than I orignially had thought. So, I'm not so worried now.

I heard back from Kaiser Vallejo and I got in to a residency starting in August. My friend Charlie back in NY got into a CTICU which is awesome, but besides that, I don't think anyone has a job yet. Two people have texted me that they've passed the NCLEX.

So things are looking a little bit more up than they were a few weeks ago.

on a scale of one to ten

2007-06-12T16:32:00.000-07:00

today is like, a two.

I just got back from the Kaplan thing: my diagnostic test stunk to high heaven. Holy moly...do I remember ANYTHING at all? I guess going over the questions now, I see that I was putting down answers per hospital policy where I was for integration and they have some whack idea about stuff (for example, at my hospital it was "no name band, no meds" but here they would have you ask a child his first and last name before administering medications...riiiiiiight.)

So if the NCLEX is like this, I have little hope of passing it--these safety measures have been beat into us, where am I gonna learn this whack shit Kaplan thinks is gonna be on the test?

AAAAANYway.

I'm also pretty bummed out that every time I turn on the tv I hear a song from MY Generation (X, if you must know) selling products in TV commercials.

The Jam selling Cadillacs, The Dandy Warhols selling Pontiacs, The The selling M&Ms...I can't take it anymore. Does this mean I'm middle-aged?!

Don't answer that.
I like to think it just means that people my age finally have discressionary income and we're a target market again.

"again"

we dropped out of it in the 90s...now we're back...yeah, we're middle aged.
I blame the baby-boomers.

Technology blows

2007-06-11T10:53:00.001-07:00

Just as I'm relying on my cell phone for a call back from potential employers, the thing goes south.

It's working, but the charger won't charge it; not sure if it's a problem with the charger ($20 would fix this problem) or the phone (need a new phone)

I'm betting on the latter.
And of course, this is how they lock you into another two year contract because you HAFTA have the treo with the GPS and bells and whistles (they know me, I'm a sucker for that stuff)

So, I'm off today to see about that problem.
And my ATM card stopped working, gonna go deal with that too.

Tomorrow I start the Kaplan review and I'm somehow terrified that they'll tell me I can't even pass their sample tests :(

Yes, I'm that dumb...I have a problem with memory since my PTSD...can't seem to make stuff stick. I can remember addresses and phone numbers and my old driver's licence number and old bank account numbers, old stuff, that I had before the PTSD. Everything after that is only held onto for a moment and then it's like I never knew it, so I'm worried I've already forgotten all this ivy league BS.

So, anyway, don't get mad at me if I don't return calls or text messages...my phone is being a punk.

Love ya all!
Lisa

The haps

2007-06-08T10:14:00.001-07:00

Wow, I've been in touch with some friends, and no one has had any luck finding a job. I think the RN licence is the make/break when recruiters are talking to us.

I'm feeling great, physically. I feel ten years younger than I did in New York. I don't know if it was the food available to me (I've lost 6 lbs. since I've returned and started eating right) or the sleep-deprivation, or the pace of life there. I used to feel my pounding heart every minute of every day, and pray I wasn't going to die of an infarc walking into the subway, getting stepped over, and kicked as people passed me while my face was turned to the sooty, wrapper pile in the corner.

So, I just got a text message that another one of us passed the NCLEX. I'm happy for her, but I'm a month off from taking it (does it matter in the long run? no.)

Where's my thinking now? Study, Kaplan, test, pass, job, fix the house, fix me, pay off bills/tuition debt, and get on with my life!

still jobless

2007-06-05T10:51:00.000-07:00

I shouldn't care. I should be focusing on studying and preping for the NCLEX. I've submitted maybe 40 resumes to different jobs and residencies...still nothing but rejection.

Not much to tell otherwise. Been cleaning the house, organizing, trying to gather up stuff to donate and make room for the things I actually need and use.

aaaaanyway, not much to tell.

well, I guess Columbia is out

2007-05-28T16:56:00.001-07:00

As I'm sure they knew, it's not been easy to find an ICU job.

I did veg out for a whole week, and got nothing done. The next week, I started tackling the forms for permits, taking the NCLEX, signing up for the Kaplan review, etc.

No word back from any of the places I've submitted my resume.

I am going in tomorrow to get my live-scan fingerprinting done so I can finish this application and send it off, already.

Then, I guess I'll drive around to various hospitals with my resume and see if I can get someone to look at it--and maybe sneak a peak at some ICUs.

So, I guess now without 50 weeks in, I'm not a candidate for going back to Columbia...just like they've set up their little program to be now.

Here I am, procrastinating

2007-05-21T21:55:00.001-07:00

Well, yes and no.

A million things to do, a zillion boxes to unpack, forms to fill out, job to find, etc.

I signed up for the Kaplan review (there goes five bills) but hopefully, it will get me back into gear...I feel like I've forgotten everything! So, the hard thing is going to be sitting down and pimping myself to an ICU as a new grad. Still no word back from UCSF and their new grad program (sigh)

Today, I made myself so busy that I couldn't possibly get anything done. I sorted through two bookshelves and recycled 2 Trader Joe's bags full of magazines (back issues of Surfer and Organic Style, snif!) I also gave the dog a bath, started the lettuce seedlings for the oak wine barrel that was invaded by weeds while I was gone, and trimmed the boxwood hedge that was threatening to grow over the front gate.

So much to do.
And so unmotivated.
Maybe I'm just tired.

It's finally over?

2007-05-13T15:05:00.000-07:00

I can't believe this hellacious year is finally at an end.

it's been fast and slow, somehow.

I guess the changing seasons make it seem faster. You know, by the time you get used to the cold, and drudging around in the snow, it thaws. You never get used to the heat, so I'm not even gonna GO THERE! Haha.

So, I guess tomorrow we have a meeting at 1 pm with the director of the anesthesia dept. (walk from the stage, to the office) I'm only going to lend moral support to my peers, of whom I'm quite fond (a few of them, not as much...but most of them, pretty good people.)

I'm really planning on having a harder year this year coming up due to trying to find a job, studying my butt off for the NCLEX, studying my butt off for the CCRN, studying my butt off to be able to cut it in an ICU...study, study, study.

I really hate the way this blog became a place for mostly bitching but...hey, there was so much to bitch ABOUT.

I heard a rumor that this next class coming in is even bigger than ours (190 people!!) oh mother. If you thought it was hard to get them to get organized and deal with US...what's this NEXT class in for? LOL.

Also, they had trouble placing all of us for integration...how the hell are they going to come up with so many more placements? I think most of the ones they have now should not ever be used again...this means that next year someone is going to get stuck with all the same shitty preceptors that we had.

Oh well.
Not my problem anymore!
w00t!

Mom's day, does this shit ever get any easier?

2007-05-13T15:01:00.000-07:00

crap. another day spent thinking about my mom.

Tomorrow I graduate, and walk across the stage.

No one I know will be there (besides these jerks I go to school with, heh)
but I know she'll be there, in some way.

It's been three years, Mom...How I miss you.

it is...O - V - E - R ! ! ! !

2007-05-07T16:34:00.000-07:00

WHAT a frigging day.
I can't believe how bad it was.
Several times, I got teary eyed and almost started crying.

I got yelled at by the unit clerk when I asked her how to fax the floor that was receiving one of our patients. She yelled at me "You've been here two months and you don't know how to use a fax machine?" I apologized for bothering her, told her that my preceptor had asked me only to fax the form and I didn't know the phone number, and I had only used the copier function on this machine, I'd never faxed from it.

"I know, I'm sorry, but I have like 40 people asking me things all day long!"

again, I apologized and said I didn't know who else to ask, and I was sorry...I knew she was busy. So I tried to find a phone directory or list of numbers or something. I almost went over to the unit to ask them their fax number.

So, then she felt bad I guess and she came over and tried to tell me the number and how to do it.

My preceptor came out and asked me if I'd called the unit and given report and faxed the form just as I wasgetting around to it.

"ask Clara, that's her job"
"I did."
"and?"
"she yelled at me"

She laughed and said she felt bad for sending me off without enough info, and said she hoped that I would come back to her and tell her I didn't know how to do something, but I said "I was trying to figure it out, to help you by not bothering you with every last detail."

pretty much, that was what the whole frigging day was like.

My regular psycho-bipolar preceptor was there, and she was extra nutty. I was glad I wasn't working with her today. I said hello to her and she just ignored me.

Okey dokey.

At lunch I went in to Cheryl's office, (my liason) and she was in a meeting so I said I'd be back. She ended up coming by when I was walking out...I spent all frigging day online, reading email, goofing off. I can't DO anything so I was trying to find things to do. My patient was a cocaine-induced MI so he was sleeping for two days, and waking up to fill his urinal, and to take his meds, and that was that. Not much going on with him, not even on an IV. When she came by, she gave me the evaluation to fill out and sort of scolded me a bit. Never to write emails and leave a paper trail that sounded paranoid, that I had to get over it, etc.

I was like "wait a minute...I feel completely robbed here. I spent $70,000 on an education and I'm leaving here not knowing much more than when I started integration." Paranoid? You're my Liason! You're supposed to be the person to help me out of this mess. Argh!

Anyway, she showed me the evaluation my freak preceptor wrote for me...mostly 3s, two 4's (figures) on a scale of 1-4, 4 being exceptional, and 1 being inadequate or something.

Right now I'm so sad that I came to this school.

Such a waste of money.

Go anywhere else but here...save yourself 50 or 60 thousand dollars and learn stuff for real...that's my advice. I wish I'd listened.

Speaking of Crazy...

2007-05-03T05:55:00.000-07:00

I'm off for three fabulous days, and the weather reminds me of home in July. It's nice. 60 degrees and not a cloud in the sky. The kind of weather that makes you smile.

Yesterday we had a meeting with a higher-up to discuss the crap way we've been treated in the anesthesia department. The new director hasn't given us a moment of her time, dedicating herself more to the MSN students, and we're like the step-children in a victorian novel, locked away in the attic.

The long story made short: the new director has made it so that we can't take an extra year off to work in an ICU, or we'll forfeit our spot in the master's program. It's unlcear whether we're to have 50 weeks, 11 months, or 1900 hours of ICU experience, since we've heard all three. And, no one is hiring new grads directly into the ICU without previous experience in a step down or regular med-surg floor. So, how are we to get this year's experience? They've tightened restrictions because this is an accreditation year for them here.

Right now, I'm just depressed. I woke up and couldn't get out of bed for about an hour (that's not like me) and I just lay there and thought about everything. I hate everything and everything is heavy-feeling.

My preceptor wouldn't fill out my evaluation and go over it with me, but instead, I had to go back yesterday and put the form in her hand (that she said I never gave her, but has been sitting in her box for 2 months now, since day one) and she told me to come back later and pick it up.

On the one hand, I'm glad I don't have to see her again--she just grates on me...she'll start off saying one thing, for ten minutes, nag nag nag, and then you realize it's turned into a sort of "why you'll never be good at this" tirade, and you're unwittingly nodding mindlessly repeating your numb "yeah, mmm hum, right....yes" agreeing with her.

I just want a rest.

But I also feel like I need to hit the bricks running when I get home...I almost want to step off the plane with a stack of resumes, and go straight to every ICU between SFO and home and drop them off, shake hands and fill out applications.

When you voice this stress over getting a job and starting within two weeks they say "other students have done it in the past" to which I say "yeah? Under Eileen? and her Accreditation Crack-down changes that make it look like this is such a great program?"

I think I'd better get out and walk around today.
I've no idea where I want to go, but just out. Hop on a downtown train and go wandering around somewhere worth seeing. (San Fran, perhaps?)

I"m still hoping and praying I'll get into Merritt, but I'm looking at anesthesia programs at USC, Fullerton, (my next two dreams) then Arizona, Minnesota (both the Minneapolis school of Anesthesia and the U of M--how ironic would that be?) Michigan, U Penn (Laura, need a roomie?) and Downstate in Brooklyn,to name a few.

ANYTHING but COLUMBIA.
What a waste of $70K this has been, seriously. I could have gotten a BSN for a fraction of the cost. (I KNOW...YOU TOLD ME SO!) :)

When people said "Don't go...it's BAD" I had no idea how bad really BAD could be. So, now I know.

I picked up my white coat the other day; did I say this already? It's embarrassing and I don't even think I'll put it on--the sad truth is that as an RN you could NEVER wear a white coat, unless you're preceptoring or something...you'd get beaten down by the other nurses who would look at you like you want to be, or think you are a doctor, and you wouldn't know shit about shit.

Why they give us these things is ridiculous...the nursing pin would have been more meaningful and appropriate. But too many people were coming here, getting the (overpriced) BSN and never coming back (and, we all know why)

The white coat (a $14 item) will go into the back of the closet for eternity, until such time that I pass my MSN.

In protest, I probably won't put it on, but continue to carry it.

Ah yeah, you know how my unit won't let me draw blood or put in IVs?
My friend Shannon is in the CTICU; they've been letting him pull out Swans.
How do you like that?
(for those of you that don't know, the Swan-Ganz catheter is (usually) a triple lumen cath that is inserted thru (usually) the right IJ (though this pic shows it going into the left subclavian, I've never seen it there) and is threaded thru the heart all the way to the pulmonary artery. Remember, my friend Shannon is on the wire, pulling this out, and I can't draw blood with vacutainer and butterfly needles)

Ding, Dong...

2007-05-02T05:48:00.000-07:00

I'm THROUGH with her.

Yesterday was my last day with my regular preceptor, but I still have 4 days left to complete with the cool, younger, more patient and tollerant preceptor.

The nursing manager checked with hospital policy--I AM supposed to be learning to start IVs, and drawing blood.

For whatever reason, my bitch preceptor just flat out refused--first it was my school policy, then it was the hospital policy...people just piss me off.

Anyway, I'm through with her.

I gave her a much undeserved gift and she chose to not open it in front of me, but read the little note I had attached, thanking her, and she hugged me an odd, upper body, shoulders only sort of hug. Kind of like "yeah, whatever..." (pat pat pat)

I told her that if she already owned it, or didn't like it, she could exchange it, to which she said "you shouldn't do that, why do you do that, you're like my boyfriend, he does that all the time...you shouldn't undermine what you do"

She then took me out to the bulletin board and said she had something she wanted to give me. She took down a piece of paper and made me photocopy it. Reading it now, I realize why she was so seemingly annoyed by me...I can see why this haqs so much meaning for her, and perhaps I can remember when I used to feel like this too. I'm also proud to say that it's something I already do, and I've gotten here on my own, without this piece of advice. It says:

PROMISE YOURSELF
To be so strong that nothing can disturbe your peace of mind.
To talk health, happiness and prospecity to every person you meet.
To look at the sunny side of everything and make your optimism come true.
To think only of the best, to work only for the best and expect only the best.
To be just as enthusiastic about the success of others as you are about your own.
To forget mistakes of the past and press on ot the greater acheivements of the future.
To wear a cheerful countenance at all times and give every living creature you meet a smile.
To give so much time to the improvement of yourself that you have no time to criticize others.
To be too large for worry, too noble for anger, too strong for fear, and too happy to permit the presence of trouble.

Now, reading that, I understand why she hated me; why she made my days so difficult, why she resented me so much. Why she was interested in Buddhism, and wondered about getting closer to the feeling of letting go that she so needs.

I hope she gets the peace in her heart that she needs to be happy.

14 and a wake up!

2007-04-30T14:36:00.000-07:00

w00t!

I can't believe this is almost over!

Just as I was gettng used to this level of misery, overwork, bordom, ennui etc...IT'S TIME TO BLOW THIS POP STAND!!!

We received an email today saying that our White Coats are in the ETP office, we need to pick them up and that we need to IRON them and CARRY them to the ceremony...LOL

I have one more paper I'm working on; a case presentation of one of my patients who had had a BT shunt (Blalock-Taussig) at 16 and a Fontan at 24. Seems odd to have it so late in life, but after reading about it, I wonder if this is what Steve, my physics prof, has had. I haven't heard from him since last summer. The emails have stopped. Men are peculiar, especially the smart, funny ones. (shrug)

So, I've been trapped inside on this lovely sunny (but windy day) reading journal articles and writing my butt off.

I'm looking forward to finishing the presenation of this patient, because that's the last day of class, and I have 3 days off following it. I might go downtown and meet my friend Eric (Hey Eric!) I couldn't make it to the Asado he and his wife are having for their new baby, Zephyr (coolest name, or what?) and while downtown I might try to see if I can find something for my non-official preceptor, Flora, whom I adore. A few of the ETP anesthesia/acute care peeps are planning on a night of some billiards and LFTs (liver function tests...i.e. "drinking") Also, I need to hang out at the MOMA alone for at least one day, to clear my head of all the ugly I've seen here. I can't wait to go home and paint and sketch again...there's been no time for anything here.

For the preceptor that I don't adore, nor loves me, I bought her a hundred dollar collection of 6 CDs, with the librettos for some of the best Operas ever written. I wish I could afford such a thing for myself. We've discussed opera a bit, she likes to go, but I still don't get the American "Opera is a high end, snob activity for which one must put on all one's bling"mentality. Fuck that. I love Opera in Italy, which is for the people. A ticket costs as much as a night at the movies, and is frequently more enjoyable. In Florence, we used to go to the Opera Comunale; in jeans and tee-shirts and fit right in with the rest of the community.

I miss Firenze.

I will start to look for an apartment in Florence in earnest once I am done with school. It's the complete antithesis of New York. As long as it's got an extra bedroom (for you free-loading bitches :P) and a terrace where we can enjoy a nice red and some cheese at the end of the day and call down to the piazza "Ciao!"

Ahhh, I miss Firenze.

rebel without a clue

2007-04-27T19:43:00.000-07:00

(sigh)
I am hating everying.

I went in today to talk to my liason...give her the letter from crazy.

She laughed and said it was a damned fine evaluation...great even.

Anyway, long story short (is there every really such a thing) I asked her what she thought about the this business of Columbia ETP making it so that we need our 50 weeks ICU experience BEFORE stepping foot back in the MSN program, and they referred me to Judy, the dean of the nursing school.

So, I went down there to talk to her.

She was surprised about my concerns and offered to look into it.

So, I emailed everyone in the program (no sweat...there are 6 of us)

Not that I care, because I sincerely am hating it here, and want to go home more than anyone can imagine...but it's the principle of the matter...
Just who the hell do they think they're EFFING with, here, eh?

As we say in Italy "Aaoh, che cazzo...?"

As an aside, I'm thinking of chanign my name...I really hate it.

Any suggestions?

WTF IS THIS?!

2007-04-26T15:52:00.000-07:00

SON of a BITCH.
is this true?!
My favorite place to hang out and meet friends, or study is closing well before I can come home to say goodbye.

(sigh)

my hilarious meez avatar

2007-04-26T11:07:00.000-07:00

OK, so this is what I'd look like in nursing whites, with pinstriped pants on, if I were at a gay rally holding one of Frank Chu's 12 gallaxies signs...LOL!

just made my invite

2007-04-26T08:28:00.000-07:00

I'll print one or two of these up and post them in the Nurse's Lounge and at the nurse's station. I RSVP'ed that 10 people were coming--optimistic, LOL!
I realize this cuts off some of the links to the right, but if I make it 400 pixels wide, you can't even make out the writing...so that's where it's at.
As we say In San Fran "Deal wit it, bitches"
:)

Miss you all a bunch!

The Set-up

2007-04-25T17:20:00.000-07:00

The acute care/anesthesia students have come to one concordance: they've set us up to fail. There is no way in hell that we will find jobs in ICUs within two weeks of finishing up here. Even the CCU has a trainee program that STARTS in August. Krystell has already submitted an application and letters of recommendation, and says that a few other ANES people are pissed off and feel cheated.

Cheated? Yeah. We could have gotten BSNs from anywhere, and not ended up $70K in debt. They made it sound like it's 1-2-3 and you end up with your CRNA at the end (like the proverbial pot of gold at the end of the rainbow...it's not there)

So here is my understanding of my life as it is: I owe 70 grand, plus credit cards. I will probably have to work my way UP to an ICU, and then the ICU for a while before even being able to apply for the MSN-ANES anywhere else.

My life for the next year is all about getting what I need, education-wise, and fluffing up my resume by getting my CCRN and other such things.

as a side note (of humor and interst) my preceptor finally agreed to write me an interim review, and wrote me the following letter:

"On clinical performance:

She has a good communication skills with
patients, their families and other allied health workers. She is
compassionate and caring to the patients and their families and her
ability to communicate in Spanish is a plus.

Her background of Anatomy and Physiology is excellent.

Administration of medicines is safe and
accurate although she needs to pay more attention to the scheduled
time. Perhaps her lack of experience is the reason for this.

She is very much aware of her limitations and
comes to me for guidance without hesitation. She however limits
herself in independent practice for fear she will get me into trouble.
I have encouraged her to have more faith in herself so she could get
the maximum experience I allow her to do while still maintaining safe
practice for both of us." (actually...it's not for her...it's because I don't want to kill an acutely ill patient with an idiotic medication error. I could care less about her or me; I'm insured, and it's her licence on the line, not mine)

"Overall, it is a pleaure to work with Lisa as
we all know her.

I wish her all the best and happiness she will
find in her role as a Professional Nurse in the near future."

WTF?

Anyway, because I had to call in this morning to see if she would be in, I completely forgot I had CLASS TONIGHT untill I saw Krystell who said "so...I guess you skipped class tonight?" and I had my "D'OH!" moment.

Holy crap, I don't even have a case study written up.
SO that's what I'm going to do now...and email it to the prof with profuse explanation of my screwball preceptor and changing schedules upon whim.

Love you and miss you all
MUAH!

my preceptor hates me

2007-04-25T09:10:00.000-07:00

but, at least it's mutual.

I sent an honest email to my liason, and the coordinator; they're always so flipping mad to hear of what's going on. I told them she refused giving me an interim review and today I got back an email saying "either she does it and it's in my office by friday, or I'm going to the nurse manager"

Oy vey.

My preceptor and the Nurse manager don't get along. During meetings, they get into these long heated debates, it's like clash of the titans; will against will. Everyone just sips their coffee and makes eye-contact.

The nurse manager likes me and would probably come down on my preceptor, but you know what they say: shit rolls downhill.

And I'm at the bottom of the hill, here.

(sigh)
Time for my lunch hour nap.

"the bitch, is indeed, crazy"

2007-04-24T17:31:00.000-07:00

I say this with fistfulls of my own hair (ok, not really, but metaphorically)
My preceptor is whack.

So, we're supposed to be getting written midterm evaluations, which I told her about two weeks ago. So I reminded her today. At the end of the day she comes back to me with a blank form and saying she doesn't want to fill it out, because she doesn't want to base her evaluation on just what she's seen me do.

The form is fairly simple. Rate me from one to four (four being exceptional, one being unacceptable) on things like interviewing skills and thorough chart review, Differentiation of normal vs. abnormal assessment findings. Documentation of care, etc.

She said "I have no problems giving you a 4 when it comes to 'aware of own limitations' but in things like 'administration of medications' I can't say"

I think she thinks I am an orientee and is thinking whether or not I'm ready to be on the floor, alone, by myself. She's given me two patients of my own, but I won't let me do venipuncture, or start an IV (wtf?) but she makes me hang potassium (which could be lethal) and give narcotics. Oy vey.

I work for a total of 9 or 10 more days (a few of them with Flora) and I will put this whole experience down as a Buddhist lesson in patience.

AAAAUUUUUUMMMMMM

PS, I want to buy this tee shirt:

Spring has Sprung

2007-04-22T17:52:00.000-07:00

Thank you to everyone who called me, to wish me a happy birthday--it really made my day :)

Today, I decided to go down to Washington Sqaure park (you can read about the history by clicking here)

and here

I wanted to come here the other day, but I got a late start, and so I didn't. I guess the impetus is that every time I've ever seen a movie or tv show set in New York, the dang arch shows up. (Remember "When Harry Met Sally" when she drops him off at NYU right at the arch? That, for some reason, stayed in my mind)

So, I took the A train all the way down there (took an hour) and came out on West 4th street. I like the sign below, sort of like "Welcome. Whatever it is you came here to do, it's not allowed; please take it elsewhere (unless you came to stand stark straight with children, and pick up trash...then you're quite welcome!)

No one told all the people with dogs and riding bicycles that it's not allowed here. And it's a damned good thing I left my martini glass at home!

The arch is lovely; not as nice as the Triumphal arch in Paris, nor the Palace of Fine Arts in San Fran (which was also constructed of papier mache, then made permanent as this arch was) but it's pretty none the less.

I didn't know this, but there's a statue honoring Garibaldi there. Seems the area was inhabited by the poor and working class Italian imigrants, back in the day, and they wanted a statue to commemorate Garibaldi's victories as well.
NYU owns much of this area. Everywhere you can see students, and they were having a big barbeque in the park and took over a whole section of it. I can't say I wasn't envious and didn't think of how shitty it is in Washington Heights. Quite a different Washington altogether!

I really liked this neighborhood.

I wanted to live right here, in this little place (though, in the winter, this must SUCK! If I had to, I could live here, or the west village, or soho...I like these areas.

I walked around for an hour, then went to the park to chillax for an hour or so. There was so much live music (a really great jazz combo that was getting drowned out by al the damned hippy jamborie, tambourine fest/greatful dead/phish covers...blech!) Such a ruckus! (it was great!) I later went to get a slice of pizza, and checked out the area. It reminded me of Telegraph avenue in Berkeley, meets the French Quarter of New Orleans, and maybe a little of Amsterdam, too. (without the "Coffee houses")

There was also a street fair going on and it reminded me of the San Lorenzo market in Florence. All sorts of stuff for sale, and food, and pick pockets galore, I'm sure (one of the pockets to my bag were undone, but I don't keep anything in here, so sad surprise for Mr. Stickyhands, LOL)

I thought to myself about how in the last month or so that I'm here, I'm actually starting to enjoy it. I realize it was the weather, the program, taking 22 units, my health, being away from home, etc.

I guess if I have to come back in a year, it won't be so bad.

Today was an odd day.

2007-04-21T16:54:00.000-07:00

I'd like to say it was a good day; it was--for me; but a patient died on my unit, so I am hesitant to call it "good day" overall. No wars ended, no cure for any disease was found.

But, if we are to carry out this philosphy, there is some tragedy happening somewhere around the world, at any given time; does this mean there are never to be any days described as good days?

I suppose I tend to wax philisophical in the face of death.

Let me start over.

Today, my preceptor was in a good mood. She assigned me one of her two patients and gave me access to the pixis drug dispenser, and webcis, for charting. For twelve hours, I had everything to do--give meds, answer his call bell, charting, drawing labs, inserted a foley (much to his horror) and provided all the standard nursing interventions which make up a day of care in the CCU.

I loved it.
The day went so fast, and I learned a ton. My preceptor and I got along like friends--she touched my arm when talking to me...this must mean she approved of me today. Either that, or she had taken her medications.

When she told me she wouldn't be around tomorrow, I said "neither am I, It's my birthday." Unknown to me she collected money from everyone and bought a cake for me.

We even shared lunch! Suzie, the ICU tech frequently cooks and brings in food to share with everyone--it's very Philipino to pot luck and share food in a communal fashion; it's kinda nice. So she made a big pot of white rice and some mung beans that were really good (some acorn squash, spinach or similar greens, pork, and a hint of some type of pepper...it had some kick) and my preceptor kept urging me to eat.

Afterwhich, someone showed up with the cake, and they sang happy birthday to me. I was touched.

Even if they didn't get my name right :) (that's Philipino and Spanish for "Lis")

And then, I was touched to see a message on the assignment board someone had written.

I didn't cut the cake right away, because of what happened in my community placement. I was afraid that there was some weird ritual of cake cutting that I didn't know about, or that 45 people would have to get a slice because they chipped in. No such--these guys are normal. So someone later said to me "go cut your cake!" and when I walked into the lounge, someone said "hey, cut that already so I can have a piece!" So I did.

As I sat and ate a bit of it, someone walked in and said that the lady next door was in full code. I put my cake down and went over to see if I could help.

She came back, for about 20 minutes, but then went into full arrest again, and this time, they couldn't revive her. So with the taste of my birthday cake still on my lips, she died in front of me. Her family showed up within the hour and I was very sad to see them. I wish they could have been there. I guess dying in an ICU isn't like dying in another place, where you can go peacefully--there is no way to have the family there watching all the crap that goes on.

It was much calmer than I thought it would be...none of that shit you see on ER or any other television show where they're all screaming at each other and the paddles are brought out, someone screams out "CLEAR!" or "GIMME TEN CCs OF BLAH-BLAH..STAT!!" That's just bullshit for tv drama. Or maybe it's just that these folks are not healthy people with so much to lose. They're already one foot in the grave, many of them waiting for someone somewhere to die and donate a good heart so they can go on living.

It was all about anesthesia getting her an advanced airway, (yep, just like the ACLS guys were saying...bagging way too fast, once every second or so) they gave her compressions every now and then, some epi, some atropine, a little bicarb, and then it was over. No one raised their voice, no one broke a sweat--business as usual at the CCU.

Blow out the candles and make a wish, Lis; the lady next door is dying.

Ah, life is like that sometimes.

I knew this day would come

2007-04-20T04:20:00.000-07:00

This morning, I dragged myself out of bed after about 4 hours of sleep and got into my ugly blue uniform, with the synthetic, scratchy pants, and the ugly white shoes...who knew I had such an aversion to white shoes? I swear I'm never wearing another pair of white shoes ever again...and I dragged my tired ass to the CCU.

When I get there, I look at the schedule and my preceptor isn't on it.
I have somehow added in a day that she was off. So, my other two preceptors weren't there either, so I had to just turn around and come home.

Not had to, I was feeling guilty, like I made it happen by dreading going in today--I wish I didn't have to...I wish I didn't have to...that sort of thing.

So, I guess I'll hop back into bed for a few more winks of shut eye, and then get up and start my day over.

Yay!

I'm so tired

2007-04-18T08:38:00.000-07:00

So very tired.
I'll be 41 next week, but that's not it. Everyone is dragging ass.
Even the 20 somethings.
That makes me feel better...at least I know it's not the MS.

I have a crazy schedule this week. Seems like they tell you you can't/shouldn't work more than 3-4 days a week, and then they tell you that if they go to visit you and your preceptor is there and you're not, you'll have some explaining to do.

So, my schedule for two weeks is like this: on three days, off one, on three days off one, on three days off one.

These are 12 hour shifts we're talking about, and I should say, they're twelve PLUS hours with my crazy preceptor. So, I'm doing like 6 days a week, almost.

If they overlap you and put all your free days up front in the week, and on the back end of the next week, it ends up that you work like a week straight or more without stopping.

And it sucks.

I'm so beat, I couldn't do any of my homework during the week, so I had to get up today and do it all before class. It's half-assed, too...but we've never gotten back any of our past assignments so we have no idea what we're doing.

screw this.
I can't wait to come home.
26 days.

Saturday night bar hopping

2007-04-15T08:27:00.000-07:00

We all met at Coogan's, a sort of sports/karaoke bar around the corner from school. And started the festivities...

Catherine was hiding the school uniform under a hoodie...school spirit, she came straight from clinicals!

Gretchen, Aric and Arthur singing something on the karaoke screen

Mahogany, Krystell, Wilson and ?

Arthur finally got up and sang "I got friends in low places" and brought the house down...we did our best to support him.

then Aric got up with Krystell and sang Van Morrison's "brown eyed girl"

Aric's girl, Claudia did her best to remind all that this is HER guy...LOL

Then, someone said something to the guys about there being a place that had burgers and fries up front, alcohol and club in the middle, and porn in the back, so naturally, the party moved there. Love was all around, as everyone but me and Cindy were paired off with their S.O. (and Arthur and Mahogany let out with the fact that they've been dating since summer...WTF?)

We first went to the burger/porn/club place. It's called POP (on 9th ave between 14th and 15th)
Going thru this portal, you are hit with loud music, and the door guy looked like Marcelus from Pulp Fiction...he looked at my ID and said "ok Miss California" as he let me in, and Gretchen was "ok, Miss Iowa" LOL

A lot of 40 something guys in the club district. They go out in hoards, in their suits and hang out outside and smoke and check you out as you're going in. Sort of had a European skeevy quality about it. But honestly...I think it may have been the tastiest burger I've ever had!

Then Aric knew about some swanky-ass place on the roof of some hotel around the corner, and we stood in line and went in after about 20 minutes. I should have gotten a picture of the inside...it was very sleek and "Jetsons" like the clubs in Europe, but despite the great music, no one was dancing! it was like a stand around/sit around and be seen kind of thing...New York clubs are weird! they're about the scene and not having fun, it seems.

This was the elevator ride up in the swanky hotel (hotel G? is all we could hear) on 9th and 13th streets, off the 14 subway stop.

the only place we found was the outside roofdeck, so we hung out there (with all the smokers, blech!) but the view was nice...made me homesick, a bit.

From here, we decided that it was late (2:30) and we all had a day of writing clinical logs and case studies ahead of us (and blogging) so we called it a night.

my bipolar preceptor

2007-04-13T09:46:00.000-07:00

Maybe because today is Friday the 13th, maybe because it's the 3 year anniversary of my mom's death, I don't know...but today was a tough day.

I'm on my lunch hour and forty-five minutes. This is because we start at 7am and she likes to take her lunch at 11, and she doesn't stop at all, all day long, so she adds her one 15 minute break to that hour and a half...then, she doesn't leave when I do (so she sends ME off at 11, but leaves herself at noon) then when I come back from my lunch hour and forty-five, I sit around for another hour or so, farting around on the computer, looking at my email, reading up on procedures...

whatever.

So, last week my preceptor was realy sort of down. Very laconic, curt even. I'd ask her stuff and she wouldn't even answer me.

Yesterday she was ecstatic, almost orgasmic, all day. Laughing a little too loudly when others were upset about something (one of the Fellows was really mad that an admission hadn't been reported to him before they came and she was cackling)

Sheesh. Was she on some mood elevating drugs? It sure seemed like it.

She was up up up (as Homer Simpson said "The dizzying highs, the terrifying lows...the creamy middles...")

Only, no creamy middles. It's all highs and lows with her.

Yesterday I got a ton of info, got to do a bunch of stuff and it was all good.

Today, she sort of cornered me in the med room and said she was surprised I didn't know about certian things with the IV pumps. She acknowledged the things I'm good at (mechanics, like understanding the swan ganz and how to zero it) but things like the IV pumps, and the fact that I didn't know where something was going to hang on a patient that has about fifty lines.

Again:
Whatever.

She said she wants me to get more confident, yadda yadda, and basically this means giving meds by myself, which I know my school is dead against. But she really wants me to despite the warning in the preceptor handbook.

Again:
Whatever.

Now I know why yesterday she said "why don't you go into teaching, or research?"

Nice. Is that your way of saying that I'm not up to the task?

I'm supposed to be LEARNING here, not coming here to show off what I already KNOW.
I don't KNOW SHIT yet. I can't get her to understand this. The other nurses are asking me why she's treating me like an orientee.

She's in her fifties, and has been nursing since her teens, I guess...it's all she knows so everything is so natural to her.

Evan, the night nurse was also in the ETP program and this morning before she showed up, I asked him where it all came together for him. He said it was really the orientation that did it.

anyway, instead of a nap today, I spent my lunch hour looking up the Swan Ganz catheter again, because though I haven't done it in a week, I know I'll be expected to do it again today, by myself, no prompting. (and of course, she didn't even notice I was there, after lunch, let alone quiz me or let me do the swan ganz thing.)

Also, she asked me to list the effects of digoxin toxicity, which I did, (either bradycardia or tachycardia, usually ventricular, leading to poor cardiac output and therefore things like shortness of breath, poor perfusion so mental status changes, syncope, etc) and then she said, "No, no, no; those are the effects of digoxin toxicity...what do you want to tell the patient to report to you if they start feeling, those other things are too late. So I said "palpitations, heart rate changes, dizziness..."

She told me to go look them up.

I did.

It said "Shortness of breath, changes in heart rhythm, Fainting (syncope), change in mental status,palpitations...etc."

She also got after me because I had pulled out a med that was discontinued from a patient's regimen...let me preface this by saying that I can't get into the computer, so I have to rely on HER to get ME the med list and times of delivery.

I copied the time that was written on HER sheet, in pen by her...as she told me to do.

So we go up and down on this merry go round, me trying to figure out what she wants, while getting what I need (to learn some shit.)

This is so hard.
I'm thinking maybe a CCU is a bad idea for the year off working...I might try to find a micu or sicu to go to. We'll see. I'm hoping they'll be as good training for the Anes program. I'd like to continue adding to what I'm learning here, but the thing that scares me is that Cardiac Patients are so damned acute, and on so many things, that I feel like I'll never learn enough in the next month to be a viable candidate at a CCU, let alone a CTICU.

Still, it's not as bad as what a few of my friends are going thru.

Jean?
HAAAALP!
:)

This is how bored I am

2007-04-12T20:02:00.000-07:00

I'm going to make a list of the things I say, that I realize are California-isms or surf-lingo that I take for granted people understand. Yet, I say them here and people look at me like "what?"

"No worries"
This is how I say "you are welcome." It means, don't worry about it; it's nothing, the least I could do, etc.

"Crazy"
this is how I say "very." It's like--"Pedro in the mail room cut his hair and it looks CRAZY good." "New York in summer is Crazy hot"

or, sometimes, it's stretched out as in: Cray-zeee. This is an interjection when someone is telling an incredible story and "wow" just won't do it justice. Every other interjection becomes "wild!"

"F'I" (rhymes with eye)
This means "if I..."
"F'I had a way to get out there, I'd go"

I also catch myself saying "fitty" just like in Daly City.
fitty bucks? nah, bro, that's too much scratch.

"scratch"-- money

I call people Bro and Brah (short for Brahdah, or "brother)

"howzit?"
Generalized greeting, short for "how is it going?"

"wiped" means tired
can also be "beat"

"yo" is sorta like Dude. "I'm wiped, yo."
it also means, ya get me, do you follow what I'm saying, are ya aware?

"going aggro"
This is when someone is being a trouble-maker, or is just ranting and mad, making a scene. "that dude went all aggro"

"stink-eye" When someone shoots you a dirty look, they just gave you the stink-eye. There's some Crazy Stink-eye being tossed around in New York!

"zah"
Pizza

These are just the ones I remember raising some eyebrows, and getting a funny look or a "what?!"

Now, if you'll excuse me brahs, I'm beat.
:)

Man, am I bored!

2007-04-12T17:22:00.000-07:00

I hate the week from Wednesday until the weekend. My case management class is wednesday nights, so I use up my weekends and tuesday night writing out my patient logs, and case study/soap notes and stuff...but from Wednesday to the weekend, it's a vast sea of NOTHING to do.

Bored, Bored, Bored!
Why were we breaking our necks taking 22 units this summer, 20 the next? Were they trying to break us?

Summer was nice, because it was crazy hot, and we all went out on the patio/roof deck and drank, looking up and down town, and mostly across at that ugly George Washington bridge.

So, I think I saw on myspace that this Saturday Charlie is planning a shin-dig that starts at Coogan's, and moves south. He said something about getting LFTs and I knew some liver abuse was on the way.

I wanted to go SOMEwhere this weekend...I'm feeling all pent up and antsy. I was planning on going to a museum with my friend, Ashley, who invited me to her family Easter dinner but I was SO wiped out from the ACLS class (and the two hour's sleep I got cramming for the test sunday) that I had to respectfully decline. Unfortunately, she has to work saturday, so I'm on my own this weekend.

Oh yeah, here's a pic from the other night when we all went out to the Saigon Grill. There were 13 of us total, but here's one group pic I show up in:

and the "who's who"

I've been really bad about taking pictures and downloading them to the computer, then uploading to photobucket to post here...as you can see from the pic--I'm a mess!

Yes, I look tired.
Yes, that's a much darker hair color than I usually dye it...they don't stock my "Natural" hair color here in Washington heights

and Yes, I've put on a few pounds.
The Philipinas are fattening me up, I told ya.

Back to swimming laps when I get home!

33 days left

2007-04-11T20:04:00.000-07:00

not that I'm counting...heh.

Ok, what's new...let's see.

Oh yeah, I took and passed my ACLS course (Yay!)
I was completely sure I was going to pass out, or fail or something because Crista hadn't passed the hands-on bit. But the instructor I had was awesome, and I think he pitched me a nice easy one, like he knew I was going to be a girl about it and faint dead away. He said he didn't, but I dunno...I still think I got pretty lucky with the scenario he gave me.

So, I have been on a 3 day stoke, to put it in surfing terms.

I told all my friends here about the course, and to ask for this instructor. Of course, some of these poor wankers will wait until they're working so the hospital can foot the bill. Bitches, we're already $70K in debt...what's another $300?

Anyway, it's on my resume. Now I have to pass that damned NCLEX...then the CCRN...then get into the anesthesia program in the Bay Area so I don't have to come back out here....

It's funny, though. Now that I'm done with the didactic portion of this crazy course, I don't mind New York as much as I once did. I think I was loathing it pretty whole-heartedly. Now, well...it's not San Fran, but maybe there's some stuff I can see/do here before I leave it that might take the rotten taste out.

Last night, I went out to dinner with a friend, and had some really decent sushi. Of course, it cost about 4 times what my favorite sushi place back home charges...but that's the real estate I guess. We were on the water, in Jersey, looking back at Manhattan, and it was very interesting to even be that far away from it...I sorta missed it in some odd way.

Don't get me wrong, I still hate it.

But you know...just for a moment, the whole year flashed before me. Last May, I was worried about passing physics, and bothering Steve every morning about the assignments and homework. I was cramming my last Chem class ever and worried about not getting an A...I was worried about being away for a whole year...thinking about my health, how was the weather going to effect me? How was not having a car going to effect me...that sort of thing.

Now with 33 days left on the clock, I'm looking back and thinking, maybe it wasn't that bad. Maybe there's time to have a litte fun before I leave; see some museums, sight see, that sort of thing.

I'm not thinking about San Fran yet. If I do, I'll go crazy. I'm focusing on things like Balloon pumps, and implanted pacemakers, and cardioversion, and that kind of stuff. I still have my preceptor to worry about (she's sort of taken a turn and seems to not like me so much, anymore...I've no idea what's happened to change her demeanor)

Meh.
33 days.

New York

2007-04-10T05:14:00.000-07:00

Homer and I share the same views, and similar experiences
(except for the getting chased by a pimp...but there's still 35 days to go...who knows?)

If I have to come back, I'll just burn everything so Columbia doesn't get it.

And, I'm sincerely hoping I won't HAVE TO come back.

Mac Spoof Commercial

2007-04-08T15:04:00.001-07:00

I'm so tired, I don't have the energy to sleep, even.

2007-04-01T17:09:00.000-07:00

What a tough and amazing week it's been.

So, on my unit, the nurses are so nice and amazing. I was joking today that I feel as though I've been adopted by the Philipines, because they are constantly feeding me and teaching me stuff...they're so amazing and nice.

I'm not on again until Wednesday, but Weds night they're going to a restauraunt called Saigon Grill, and said "of course you're coming" (this should be fun, they're a fun bunch.)

Anyway, of course I feel completely inadequate, like I don't know anything. My one saving grace is that I'm really good with physiology and pathophys and basic pharm, (the common meds we use over and over) so I'm able to talk through what's happening and why, so they all think I'm some kinda smarty pants (which, I'm so obviously not.)

"you're so good with the patients"
"You're so good with the families"
"what do you want to learn?"
I need it all. I don't know a damned thing...show me, teach me...everything.

We had the same pt for 3 days in a row, a super sweet guy, with acute renal failure on top of his cardiac problems, so he's confused, a lot. The hemodialysis is helping but he thinks we're in the airport, then a hotel, then a restaurant, etc.

He has two sons and a daughter. The youngest son was nice to me, but then as I walked out of the room, he turned around and ripped into one of the nurses, later demanded of the physicians an explanation why it seemed no one knew what the others were doing, and the attending...all he could do was put his head down and apoligize. Since I'd already met them and they trusted me, I was able to tell him that though it appeared no one was communicating, they were...and things were well documented for all the staff to read, and that the reason nothing had been done yet, is they were trying to rule out certian things, and wait to see if his dad was going to respond to certain therapies, or not, and that that in itself would help lead to a more confident dx. I reminded him that the clinical setting is not like running a company. You can't expect two patients with the same condition to have the same outcome on the same treatment. You can't rush this--they still don't know what's really wrong.

After the attending left with his tail between his legs, I told him not to push them to jump into a treatment. They had been wanting to do a pericardial stripping, and from what I'd looked up, that didn't look like such a hot prognosis (only 10-20% efficacy) and the risks were big...that they were not in agreement that this is a procedure that he needed etc.

My acting preceptor, Flora, said "you're so good, so confident to say things to him, he's mean"

Nah, he just wants straight talk; honest talk.

Then when the daughter showed up with her mom, I asked them about DNR/DNI and what they had in place. He had really responded badly to them trying to stick a duotube (duodenal feeding tube) in and the spouse and daughter came in to plead with the residents to stop. The worry is that he'd wither away without proper nutrition.

So, they thought they had a DNR but they had a DPOA and I told them that wasn't enough, and got the physician to talk to them about it. The spouse and daughter went home to talk about it, and read the forms, etc.

So, I did ok.
They thought I was a rock star, and the nurses were patting me on the back.

Anyway. I'm one of the lucky ones. I don't think the other student on my unit doing nights is learning as much, but at least she's learning more than a friend of mine who was placed in a step down unit.

Walking home together tonight, he told me that his preceptor is advocating against him and against students in general being on that unit. So, he's not having a good time.

Sad thing is, I think he's one of the best, if not the best student in this program. Not only academically, but with patients. So it's very sad. He's not alone...several people have shitty placements and are getting bascially ripped off with this integration experience.

I'm super lucky.
Finally, I hit a good streak.

Although, they like me so much they said the were contemplating not passing me for the integration so I'd have to stay in New York and have to come back...they don't want me to leave.

That's sweet, but couldn't I just come back to visit you all, instead? :)

The writing semester

2007-03-28T06:13:00.000-07:00

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!

Brilliant

2007-03-26T18:25:00.000-07:00

I'm a sucker for the following:

2007-03-26T09:52:00.000-07:00

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...

I think my preceptor is trying to kill me...

2007-03-23T07:29:00.001-07:00

Hah, no really.

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 CCU

2007-03-21T16:28:00.000-07:00

What a crazy experience.

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"

California, here I come.

I'm back :(

2007-03-18T20:15:00.000-07:00

I dreamed I went home for spring break...it was so wonderful!
the weather was great, the food was awesome...

:(

Ice in New York.
And my little room...sigh.

HAPPY Pi DAY!!!

2007-03-14T19:50:00.001-07:00

ah, 3.14.

What a day.
What a beautiful day!

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.

Only 4 or so days left until I go back :(

Ahhhh, Home :)

2007-03-11T18:50:00.000-07:00

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.