Externships

It's been awhile since I've posted. One of the biggest reasons is that I've started an externship in a brand new local hospital, in the ICU. Very exciting really; it pays really well, and most likely will lead to a job when it's all said and done. If I manage not to fark it up that is. And as surprising as it is to say, getting a desirable job has suddenly become more of a challenge than any of my classmates had realized. Stupid economy. Regardless, I've positioned myself to get a really great job on a really great unit, that will give me the critical care experience required for CRNA school application.

The externship has been a fantastic thing--it's unbelievable how much I've learned in the few short months I've worked there. After my first weekend of work, I realized I'd learned more than in all my clinical experiences through school. One of the biggest things I learned is that I really DO have a passion for pediatrics, and it matters much more than I previously thought. Adult ICU is very interesting, and I'm very thankful for my learning experiences.

However, what's got me really excited right now is a possible summer externship program at a local children's hospital. There are two nationally known children's hospitals in the metro area where I live, and my wife works at one, so I have to seek employment at the other. I sought some help from my pediatrics instructor as to what to include in my application, and what not to, and she volunteered to write me a letter of recommendation. She gave me a copy a couple days letter, and it included some of the nicest things anybody has ever said about me.

Anyway, I'm super excited, driving my wife nuts talking about the what if's, and I've only just sent my application in.

HawthoRNe

**Spoiler Alert** This post reveals information about the first episode of HawethoRNe, please don't read it if you've yet to watch.

Having been out of town last week, I set the DVR to record this new medical-drama on TNT, told from the nurses point of view. My wife and I finally got to sit down and watch the pilot last night.

For the most part the show was enjoyable. Jada Pinkett-Smith is a talented actress, and the supporting cast is equally up to the task. The story lines felt a little forced at times, but maybe the writing will settle in instead of trying to flex all its muscles at once trying to impress viewers enough to come back for episode 2.

There were the inevitable medical TV show flub-ups--several of them just in this episode alone. For example, when CNO Christina Hawthorne jumped in to save the day and inserted an IV on a newborn, she put the catheter in backwards--completely counter flow! And the "large vessel" she found in the baby's scalp to catheterize, well she used a butterfly... That same poor baby was on an adult gurney--good thing they put the side rails up to transport--with holes big enough for the baby to completely slide out.

Or how about the patient that went from a blood glucose level of 225 to a diabetic coma within minutes of receiving a grand total of 6 units of insulin...

I think my biggest gripe with the show had to with the sole male nurse character. It's unfortunate the show's writers saw fit to portray Ray (played by David Julian Hirsh) as a medical school reject. The reason Ray didn't get into medical school? He tanked on his MCAT. I really hate the message this sends about nurses--Ray wasn't smart enough to be a doctor, so he became a nurse. Ugh.

The really annoying thing about it is that the story line called for Ray to be smart enough to recognize a doctor had a made a mistake. Clearly we need for Ray to be ALMOST smart enough to get into medical school to make such a leap, right? Wrong. The story line wouldn't have suffered at all if Ray had just been, say, an intelligent nurse (like hundreds of thousands of nurses in practice today), in fact it would only served to empower nurses.

Some of the characters were over the top, but not unpleasantly so. The newbie nurse who has a colossally bad "first" day was a bit funny. The character of Dr. Marshall was waaaay over the top. I only hope a doctor never speaks to me in the manner she did...that will be quite a day.

Overall, I give the show an A for effort. I'll be back to watch episode 2. It was perfect, and it wasn't the best show I've ever watched, but it worked.

HESI

We took the HESI last week, and I just looked at my scoresheet a little while ago. We were told to expect to do much worse than we were used to being a standardized exam and that we were only first semester nursing students. Well, I've done the whole standardized exam thing--a couple of times--so I wasn't stressing. I did nothing to study for it, although many of my classmates spent hours on NCLEX books. It is worth 15% of our course grade and part of our mandatory minimum 70% to move on program. They told us a 750 was minimum passing, 850 was expected and 900 was a score we could expect to pass the NCLEX with.

It was a 55 question test, I missed 2, and scored a 1435.

I'll take it.

ER

Thursday was my day to go to the ER for an "off unit experience". It was pretty cool. It always helps when the nurse I'm assigned to actually welcomes my presence. She was very good at her job, and I had a good experience. Our initial patient of the day--right at shift change--had had tonsil surgery the day before as an outpatient procedure. They had bled from their tonsils and throat all night before reporting to the ER (at a completely different hospital from the one where they had the surgery no less.) Patient was in obvious respiratory distress and had sats in the low 60s. O2 through a nasal cannula brought that up to the 70s, but it took a venti mask to make it into the 90s. ER doc couldn't find an ENT doc willing to come behind another surgeon so the patient got transferred back to the original hospital--with much gnashing of teeth.

After that patient, the nurse just handed me the clipboard and sent me in to assess the patients that came in. After I did my interview and assessment I'd report back and she'd help me see what things I did well, and what additional things I might have done.

I saw a wide variety of patients. I saw an 18 y/o drug overdose/wrist slashing suicide attempt. I saw a 9 y/o with an asthma flare-up. I saw a patient with a bowling ball size abdominal tumor--CT showed mets in the liver too. I saw (and helped suture) a full skin/subcutaneous thickness and partial muscle thickness circular saw lac to the forearm. So, no major gunshot traumas or MVC's, and thankfully no chest pain patients, but I think that was probably a good thing. I got to actually participate much more because patients weren't terribly acute. ER might be a fun PRN job on the side at some point.

Checking In

Small update from this side of the couch.

The last few weeks have been full for me. School is in the end of semester frenzy and I've taken multiple tests and practicals. Most weeks I don't have a day off between school and full time daddy duty. Tests have gone well, and I've come to the conclusion that slow and steady wins the race. As does working hard early in the semester and putting yourself in a position to just cruise. Clinical has been interesting. I did my OR rotation and loved it--I may even consider being a First Assist if I decide not to go to CRNA school. My ICU rotation was equally cool, confirming to me that I can at least make it through the 2 years required for application to CRNA school. I like ICU MUCH better than the floor. My brain just doesn't divide itself 5 or 6 ways as easily as it does 1 or 2. Granted the patients are much higher acuity, but I'm totally cool with that.

The patients have been interesting. I've had a pt with necrotizing fasciitis who has had all the skin, fascia, and subcutaneous fat removed from their leg, ankle to groin. Did a dressing change on that patient where the surgeon tried to make me ill on purpose. Lucky for me I was just able to smirk right back at him even through the anaerobic funk. I've had a 51 yr/old who lives in a nursing home who came in with pneumonia. I was the one who got to tell the patient their lung cancer was no longer in remission and was in fact back with a vengeance. I had a patient who claimed to be a nurse who came in for chest/jaw pain for 10 days duration, but knew exactly what pain medication worked best for this kind of pain. Not surprisingly it was morphine. The same patient yelled at me multiple times telling me I had no common sense at one point. I finally snapped back and exposed the inconsistencies in the patient's story, effectively shutting the them up and sending my preceptor nurse into hysterical laughter. Next week is my final day at clinical for the semester and I get to go play with swine flu patients in the ER.

Mostly though, over the last several weeks I've come to two realizations.

1.) Time with my kids is a gift and I should approach my weekend daddy duty with that attitude instead of the attitude I have been.

2.) I am deeply, desperately in love with my wife. This is why when things aren't going well between us it turns me into a decimated shell of a man. That fact doesn't mean that everything is daisies. But, I don't get to choose whether I love her or not, so better to suck it up and make things work. Again, an attitude thing.

Anyway, I hope a few of you check here occasionally still. I miss interacting with you all on a regular basis. I do get to read your blogs sometimes, but not much commenting. I hope this finds you all well and happy.

Answered Prayers?

During clinical/lab this afternoon I got a phone call from my chiropractor, and don't think my heart wasn't about to come out of my chest when I saw his number. Lucky for me the call came outside a patient room because I would have answered it if I'd been in the Oval office receiving the Medal of Honor, let alone in a patient room. It's just better because now I don't have to explain myself.

Anyway, the CT w/ contrast came back "largely unremarkable with no evidence of soft tissue trauma, mediastinal mass, or large vessel aneurysm."

The radiologist was dumbfounded, comparing my first chest X-ray and my second X-ray 24 hrs later that were identical, to the CT done 24 hrs after that. She doesn't have an explanation as to why it resolved so quickly. I don't have a logical explanation as to why either. There is no logical explanation.

I'm not necessarily one to cling to the idea of miracles. I do believe they happen, but I also know that it's probably not best to depend on them. In my mind I keep ending up at the same logically illogical explanation.

So, it is with great humbleness and eternal gratefulness that I thank those of you that prayed for intercession on my behalf. Maybe that's what did it, maybe I'm just a freaky fast healer. Regardless, I'm not man enough to deny that a miraculous healing has occurred.

----||----

Today was our final day of the semester in our clinical labs. The rest of our clinical days will be spent at our assigned hospital. Frankly I'm relieved because it ends my interaction with the other clinical instructors. I'm not sure how, but mostly by pure dumb luck, I managed to situate myself to be instructed by the best clinical instructor in all of Junior 1. Since it was the last day, we filled out evaluation forms about our experience in lab--another answer to prayer I think. I hate to admit it, but I took a small measure of joy in professionally (and ever so respectfully) expressing my dissatisfaction with two of the clinical instructors. I was not the only one.

Today was medication administration to 'standardized patients' (actors) and it was a completely draining experience. Obviously the patients couldn't take the drugs, even if they were real. It was so tough to figure out where the acting began and real life began. On one hand they'd tell us information we needed to know for the scenario completely lucidly, but then turn around and try and trick us with their acting. Really tough. The woman faking Alzheimer's that threw her crushed medication mixed with chocolate pudding across the room, all over the bed, floor, and wall was taking it just a little too far. I had to give her a SQ injection of heparin too--real needle into an injection pad she had positioned on her abdomen. When she became combative and nearly made me stick myself, it truly pissed me off. It's all fun and games until someone gets hurt. There is no valuable lesson to be learned there in my opinion. But that's just me.

----||----

As so as I got home from clinical lab, I immediately went to my other job--Mr. Mom. I have the kids pretty much to myself from this evening until Sunday afternoon when my wife gets up. My last time to myself was last Sunday evening following my car wreck which I spent frantically studying for my Foundations exam. (Which I somehow managed to pull at 87 on, despite being completely in pain and only studying for 2 hours for.) Oh well, that's what being a dad means, right?

Aftermath

Mrs. Drofen has her PALS recertification class today, so I've been all kids, all day, instead of using my day off to study like I normally do. Thank goodness next week is Spring Break.

Monday was an interesting day. I went ahead and took my Foundations exam even though the events the night before kept me from being prepared as much as I'd have liked to have been. I was also in quite a bit of pain and kept mis-copying answers to my scantron. I hope my grade doesn't suffer too much, but I guess I'll find out later today.

After that I had a group project for my Health Promotions class due. We had to teach the general public about fitting exercise into a busy schedule, and why it's important to do so. We set up a table in the on-campus activity center and started handing out free water bottles and conducting a raffle for free Six Flags tickets and Chipotle Bucks, in exchange for them listening to our spiel. We gave away 4 flats of water, so 96 bottles, and had over a hundred entries in our raffle. All in an hour and a half--I was hoarse by the time we were done.

Next, I headed to the chiro to get checked out. He shot X-rays, gave me an exam, adjusted me, and did some PT modalities. I felt a ton better afterward, and didn't need any pain relievers at all yesterday. However, when I went back for my follow-up appointment yesterday afternoon, we put the X-rays up on the light box and we both immediately saw something concerning. At about T-3ish, my trachea takes a sharp turn to left. I'm by no means a radiologist, but the chiropractic education includes over 20 credit hours of radiology since we can write for and perform Xrays. There is not a simple or benign reason for the trachea to deviate in the mediastinum. The best case scenario is a contusion and hematoma from the wreck. Other causes might be lymphoma, a thoracic aortic aneurysm, or even lung cancer. Needless to say I was freaked out.

After my appointment and associated troubling news, I got to go take my first OSCE of the semester for Assessment. I was able to pull it together enough get through it, and scored a 99.17%. The only thing I missed was stating 160* nail angle as related to digital clubbing from chronic hypoxia. Doh!

This morning the chiro hand carried my chest film to a radiologist he works with regularly, and she was concerned too. Concerned enough to pull some strings and get me a same day CT w/ contrast. So at 1620 I'll be lit up like a Christmas tree. Let's hope there's no packages under that tree...

I'm doing ok I think. I'm pretty scared at the moment. I have a lot of things going for me, and a total lack of secondary symptoms to suggest a disease process. But the diff dx's that come with a mediastinal mass aren't nice playmates. I'd really like to just take my toys and go home, but I'm going to have to deal with this one.

I'd appreciate good thoughts and prayers. :(

Against the Flow

My tender male student nurse feelings were tested on Tuesday during my assessment lecture. The topic of the day?

Male & female genitalia and rectum & anus. Surely you see the male-bashing potential from just that bit of information. We'll also ignore the adolescent-silly comments that peppered the entire lecture, and move on to what really pissed me off.

We were discussing the need for STD testing, and the lecturer asked the class if we thought that a patient that claims to be in a monogamous relationship should still be tested for STD's. Of course the correct answer is yes.

But then the lecturer went on, and way too far, in my opinion.

She said, "You know these high paid executives, they run around and sleep with any little young thing they can. And then they come home and give these STD's to their unsuspecting wives who have stayed home working hard to care for their children and keep the house just the way the husband likes it."

Now, I'm positive what she describes has happened before. But I'm also certain, (from personal experience), that husbands are NOT the only people who cheat. Wives do too.

I couldn't resist it--I raised my hand and made that point. The lecturer begrudgingly agreed. But it wasn't 5 minutes later that we were discussing statutory rape, and she made another comment about how when this happens she has to "turn the boyfriends in to the cops."

Again, making the assumption that the males are the only ones who might commit statutory rape--a point that is debased quite effectively I think by the rash of female teachers having sex with young students in the news lately.

My clinical group and I (all females) were discussing this at lunch. One of my clinical-mates asked me, "What did you expect going into a female dominated world? If I (she) had gone into engineering, I'm sure that there would be all kinds of female bashing jokes and comments being made."

I responded that while that may be true, that it certainly doesn't make it right.

As nursing students we are expected to act as professionals at all times, representing our school in a respectful and courteous way. We are constantly being reminded to develop our critical thinking skills. One of the principles of critical thinking that we were tested over was the removal of bias and discriminatory language from our discourse.

Unfortunately, this lecturer apparently missed that class...

Maybe I've been over-sensitive here. And the truth is I'm up for a joke as much as the next girl. If the same words had been said in jest, I think they probably wouldn't have bothered me. What bothered me was the fact that the lecturer was completely unaware of her bias.

I'm sad to report that sexism wasn't her only downfall. She is not our regular professor, and she had a poor grasp on the material in both of her lectures. Her previous lecture was on the heart, where she informed the class that ventricular filling is what triggers the systolic contraction...without mentioning the conduction system except in passing... This lecture she made several breast cancer gaffes and reversed syphilis and gonorrhea. Not my favorite lecturer.

Shit.

I've had nurses tell me that everyone has "one thing" that they just don't do, or have a hard time dealing with. For my wife, her one thing is open, sucking, gaping wounds. They make her queasy and have made her light-headed before. But she's also a testament to learning to deal with your one thing--she's been a successful pediatric critical care nurse for 6 1/2 years now, and she does see her fair share of patients with open sucking wounds.

Well, my one thing is...shit. I don't think it's the smell--I've learned I can close my nose off pretty effectively from all the poopy diapers I've changed. It's not the sight of it either--once you're used to breast milk poops, there's not much that will faze you in that department. Unless it moves on its own. But mostly I think it's just the thought of it that gets me.

I know that a lot of nursing care is dealing with poop. I know that it's a fact of life. I know that most patients can't help what's oozing out of their ass. I also know that most patients KNOW that there poop situations sucks and it's a great source of embarrassment to them. I know that putting on your nurse face is the greatest gift you can give these patients.

But the thought of ass juice just makes my skin crawl.

I'm working on it.

Clinical Day II

Today was my second day of clinical in the hospital. I have to say that I felt much more confident when I hit the floor at 0630--I hope that trend continues.

By the luck of the draw I got paired with another awesome nurse today. My assignment was to pick a single patient, complete my assessment, and then collect enough data to write up a total care plan. Given how awesome my nurse was, I made the executive decision to tag along with her and watch her manage the care of 5 acute patients instead. As a result I ended up with doing 5 assessments instead of just one, and all before 0830. After that we started passing meds, and she was so cool. Her challenge to me was that if I could correctly name the drug's purpose off the top of my head without looking it up, I could relay that information to the patient as I...ahem...happened to hand the patient the little medication cup that may, or may not have had the medication in it. I may have pushed a few syringes that may, or may not have had medication in them as well. Of course I couldn't *officially* pass meds since I haven't been checked off on that skill. But let's just say that my years as a pharmacy tech really paid off today...

Amongst our patients today was a patient I got to know last week--a 36 y/o male who'd had a suspected stroke. He was in a semi-coma and completely unresponsive. The docs really had no idea what was going on with the patient though. He'd spiked a bad temp, but wasn't responding to any of the antibiotics they threw at him. None of his cultures were growing anything either. Such a young guy, in good shape too, and has a wife and young kids. Anyway, as the tech and I were giving him a bath today, I noticed when I was washing his back/sides he was twitching a little bit like I was tickling him. So I said something to the nurse, and he started squeezing her hand on request. Later when doing oral care on him, he was retracting his lips to help. And then he started lifting his head and following you with his eyes. When I was leaving for post-conference he actually spoke to the nurse.

That was a pretty amazing experience--he's been admitted for two weeks today, and completely unresponsive the whole time. Until today. I've been blessed with some pretty awesome experiences in my two days of clinical. I hope the trend continues, because I've heard of classmates of mine not being quite so lucky. Personally I think someone is watching out for me. I just don't think I could handle a shitty clinical experience with everything else that's weighing on me right now.

Anyway--the next two weeks we're in lab instead of clinical, so no stories of codes or miraculous awakenings. Although, stay tuned for a post where I talk shit. Literally.

Checked Off

Had my NG Tube Placement, Foley Catheter Placement, and Sterile Wound Dressing check offs today. All went smoothly, and my assessor was really nice. She showed me some real world modifications of the book's procedures, so that was really helpful.

There was a job fair at my school today sponsored by the Career Services. Several hospitals were among the employers there to recruit. I had planned on visiting between my check-off practice this morning and my check offs at 1300. I dropped by and everyone in the place was in business dress and I was in my scrubs. And the room was absolutely packed. I just didn't feel like dealing with the extra stress, so I bailed and studied my check-off material instead. I have a pretty short list of hospitals I'd like to work at, and none of them were there, so I didn't stress about it too much.

Today is Mrs. Drofen's birthday, so I stopped at the local mom & pop bakery where we got our wedding cake made to get her a birthday cake. Unfortunately they no longer accept debit cards due to all the fees associated with them. Well, I didn't have cash and I'm not allowed to carry checks, so they ended up losing a sale completely.

I've debated about whether or not to blog this next part. To blog it validates that it pisses me off and that it affects me. Remember this post? Well it wasn't long after that I noticed that she was no longer on my friends list on Facebook or Myspace. So I headed over to her blog (that she gave me the address to) and left a comment along the lines of: "Hey I noticed you unfriended me on FB and MS, I don't know that I completely understand why, but I can respect that. I just wanted to let you know that there are no hard feelings and that I hope things go well for you."

Big mistake apparently. I happened by her blog again yesterday, only to discover a long post about me. She apparently believes I am cyber-stalking her, (nothing could be further from the truth,) and claims that I have threatened her, (never happened.) She proceeds to tell me that Big Brother is watching, and that she's recorded my IP address etc, (uh, duh?!?). She says that my comments regarding her FB status quote that started all this were multi-paragraph tirades, (they weren't.) And her little crony friends all made snide comments on the post, how much of an idiot I am, etc. The worst part is where she says that we're not friends, will never be friends, and never were friends in the past. I had always considered her a friend back in high school. We had multiple honor's classes together, worked on multiple class projects together, I played tennis with her boyfriend, etc. It just makes me wonder how many people I consider friends never were... So, it pisses me off to have my character libeled like that, but I think I'm just going to let it go. The LA sun & smog has clearly cooked her brain tissue.

Just sucks getting kicked in Internet-balls for no real reason.

And that's my post for today.

Clinical tomorrow morning butt-ass early.

Clinical Jeopardy

Category:

• Nursing School

Clues:

• Insertion of a rectal tube.
• Deep tracheal suction.
• Bagging of a coding patient.
• Bagging of a freshly intubated coding patient.
• Grabbing the ankles of a seizing patient and dragging them back into bed, inches from hitting the floor head first after a doctor took the headboard off the bed.
  
• Helping move and transfer approximately 19 million patients.

Answer:

• What are things Drofen did during his very first day of clinical?
  

School Days

I remember reading other nursing student's blogs and wondering why they seemed to blog so sporadically. I thought, "Surely the class load isn't keeping them from blogging?!? I won't do that.

Ha. Here I am 4 days since my last meaningful post, with a couple of photos thrown in to pass the time.

We had our first exam of the semester this morning--Assessment. It was over a lot of material, half of which we were never lectured on because of our bad weather days a couple weeks ago. I did pretty well, having found one question so far that I know I've missed, and one question that possibly didn't have a correct answer at all. The exam had 65 questions on it, so that puts each one worth less than 2 points so I can miss 5 and still have an A.

I've been studying my butt off though, trying to get everything done. It's become more than a little ridiculous though, and near impossible to complete everything and be a participant in the outside world. I had two days of clinical last week because I'm a boy, and that got rid of one of my days off. Friday I lounged and did nothing, which turned out to be a big mistake. Saturday I started freaking out in the morning at the volume of material I had to do, so immediately after lunch I hit the books. I got most of my Foundations and Health Promotions reading finished by about 9 pm. Sunday, I got the family out the door to church, then hit the grocery store while making a pizza for their lunch. I was in Barnes & Noble (a favorite study spot,) by 1230 and I didn't get home until 9 pm. I finished my reading for Foundations, completed a LONG ASS online module, and studied 4 of 6 chapters for the exam. Monday I was in class all day long, got home at 430, made dinner for the family, and then got them out the door to small group meeting while I studied the last two chapters. Ugh. I'm tired just thinking about it. Or maybe I'm still tired from doing it.

No break though, because I have lab at 2 until 5, then home to fix dinner. Then I have yet another online module to finish before midnight tonight.

Oy.

Anyway, I hope to be around to all your blogs this evening sometime and do some catch-up commenting. Thanks to everyone for checking on me! :)

Bath Day

As I alluded to in an earlier post, today was Bath Day, or actually the instructors titled it, "Bed, Bath, and Beyond." Ha! The morning started off a very chilly 27* this morning, and the heaters in the Smart Hospital were apparently not working. I had a very chilly hike across campus since we're not allowed to wear any unapproved coats or jackets over our uniform--or we'll be written a ticket by the Fashion Police for being out of uniform. Yes, really.

Of course since I'm the solitary guy in my clinical group, and we can't have any fraternizing (**GASP**) I get to attend lab today, and tomorrow. Yay!

My experience today was startlingly trenchant. Since I was not with my clinical group, I was quite literally being cared for by a total stranger. And I found the experience completely humiliating. I was given a bed bath, complete dependent oral care, and fed nectar thick liquids observing aspiration precautions. Don't get me wrong, my partner was very professional, and was actually quite good as he's been a tech for 6 years. But the overall experience was quite demeaning. I'm just not very good at being helpless I think. My personal space is pretty big too, and I really hate being touched without my permission. So honestly I found the experience fairly violating.

I imagine I'm not the only one to feel that way. It's given me an interesting perspective--even the best care can still be offensive or not enough. And it has nothing to do with the caregiver.

Anyway, I'll be processing this day for a while.

Weekend Round Up

Here's a brief post about the last few days.

Thursday was the first day of non-orientation type Foundations Lab (what we do when we're not at clinical.) It was at our Smart Hospital which apparently is revolutionary and has been toured by thousands and thousands of school administrators and government people from several different countries. It's basically a sim lab with dummy's etc, but it's set up a like a real hospital. There are ICU suites, ER suites, pedi suites, OBGYN suites, etc. Anyway it's pretty cool. But we found out as soon as we arrived that we would be working with 'standardized patients'--patients that are paid actors, but from the community. And the kicker was that they were going to be evaluating our skills! Our skills that we had only heard lecture over, and hadn't even practiced on each other, let alone real people! Nice little surprise to generate some sympathetic responses. It was very stressful, luckily we got to go in the rooms as pairs, so we could feed off of each other. We did our PPE and hand-washing check-off and I passed, thank goodness. I was a bit worried because the gown, mask, and gloves were all about 3 sizes too small for me. In fact the gown hiked up my sleeve and displayed my shoulder tattoo, which is normally NOT visible, and the instructor griped at me, big fun.

Yesterday we traveled to my wife's home town where one of two sisters that are pregnant had delivered the night before. She was about 38 weeks along when she delivered and it was really bad timing, haha. I told her husband to get used to it, because that's how it works when you have kids, LOL! They had a baby shower scheduled at their church--which went on without her, since they couldn't notify everyone that it would be canceled. They also just bought a house and had to be out of their current house post haste. So I spent the day with my F-I-L and the husband's father and brother moving all their furniture. I'm SORE today, but it was good, we got all their furniture moved, and picked up some new furniture and a frig for them also. I couldn't believe how lazy his family was though, anything that was heavy, they arranged it so my F-I-L and I got the honors. At first it could have been coincidence, but towards the end it was really obvious. Kind of frustrating, but oh well. We got home about 6 pm (they live about 90 miles from us) and I grilled up some bacon wrapped venison back-strap. The bacon grease totally caught on fire on the grill, but somehow miraculously the whole thing ended up grilled to perfection--better to be lucky than good I guess.

Today my wife, the 2 y/o and Baby Drofen are staying home from church because the 2 y/o has a green snotty nose that she's working out. The 9 y/o and I will be going to church, and then it's school work all this afternoon. Way behind on reading since I was busy all day yesterday. And I have a couple modules to get through, so look for more Evolve QOTD posts.

Finally, here's a small prayer that Christy and her family is ok. They're caught up in the Kentucky ice storm aftermath. I was really worried last night because I hadn't heard from her in awhile, but then she posted late last night. Anyway, Christy, hope things are getting better...

Evolve Quote of the Day #2

Our instructors have chosen to use Elsevier books Evolve Learning System online modules a part of our curriculum. You may remember the gem from a day or two ago regarding making sure not to trap breasts in the gait belt when transferring patients. I'm finding enough hilarious quotes that this may become a regular feature on my blog.

In reference to ensuring the proper placement of NG tubes, the module states:

"Upon completion of this lesson, you will be able to identify signs and symptoms of accidental respiratory migration of feeding tube."

Apparently feeding tubes head South for the winter?

Evolve Quote of the Day #1

From an online learning module about patient transfers:

"When using a transfer belt on a female patient, ensure the patients breasts are not caught in the belt."

I suppose it's highly inappropriate, but it made me giggle.

But then nobody ever accused me of being appropriate...

And So It Begins...

Today is January 20, 2009, a day clearly significant in America's political and social landscape. I think it's important to note that the effects of Obama's inauguration travels far beyond the powers of a mere mortal man. You see folks, Obama is but a mortal man, with all the limitations and restrictions inherent. But the nature of the man is not where this phenomenon draws its power. Instead, albeit with no small amount of nudging and campaigning by his organization, America as a whole has taken inspiration in the moment and breathed life into this rallying cry of change. It is the conscious decision of a million individuals. They choose to believe Obama represents change, and in that belief they themselves will catalyze that which they attribute to him.

Obama is a remarkable man to be sure. He has managed to be enough of all things to enough of all people for enough time to win their allegiance. My only wish is that the American people realize that it is the people that have created change, not a candidate turned President.

Notably while Obama was being sworn in, I was sitting in my official first class of nursing school (thank goodness for DVRs). Climate of change indeed. I have to say the entire class was depressingly anticlimactic. After the frenetic chaos of pre-class exercises, homework, and reading assignments, lecture was just lecture. And it followed suspiciously along with the assigned reading.

So now here I sit, 80-odd PowerPoint slides behind me, waiting until 1400 for the health dept to accept patients again so I can get my second round of immunizations. The school library is teeming with happily chattering 5th graders...er, college kids. The computers are painfully slow--this keyboard's left hand shift key doesn't work, and the "77777777777777" key sticks. Dr. Ruth's column is still next to the classified ads in the student newspaper, just like it was in 1998 when I first came to this school.

I have a life altering decision to make in the next couple of weeks or so. A decision that could have a lasting impact on my relationship with my older daughter. Prayers for clarity of mind are gratefully accepted.

Pickled Bitter

Looking back over the past year I realize that aside from the years spent living through my dying first marriage, 2008 was quite possibly the worst year of my life. The professional disappointment I experienced following my much heralded graduation from chiro school I can describe as nothing short of crushing. It's made an indelible scar on my soul. I don't know how else to say it than that--it's affected who I am and how I see the world. I'm smart enough to know that such bitterness doesn't stay neatly compartmentalized and seeps its insidious way into the entire person. I've seen it affect my marriage, my relationship with my children, my relationship with God...

I know all the conventional wisdom about how the true measure of a man is in how he deals with failure. That's a nice and tidy cliche on paper--and I can match that cliche in real life. The truth is that yes, I've dealt with it just fine, almost healthily. I get up in the mornings. I interact with people. I have hobbies, and interests, and distractions. I have hopes, and dreams, and aspirations. I haven't considered suicide in quite some time now. So on paper, I'm doing just fine. But how does that translate from firmware to wetware?

In real life I'm deeply, deeply wounded and betrayed. And the senselessness of it all is the worst part. The school's disregard for the fact that I have a family to provide for, that I have responsibilities as a man is abominable. The clever marketing and the outright lies spirited my money and my livelihood away. The fantasy fairy tales they passed off as truths stole my children's father from them. It repossessed 4 years of my time and my life. It strangled my marriage within an inch of its life. And the school doesn't care because they got paid. I wonder how these people sleep at night? Have they deluded themselves into believing the bullshit that spews from their mouths?

I don't think I'm ever going to be OK with this part of my life. 4 years! That's 1/8 of my entire LIFE. I'm wondering if it might be best to wall this off like some infectious tubercle and try and move on. To some extent that's what I've done. Nursing school is full of promise and hope. If I can't get a job after graduating nursing school, it really is me. I have a new child that I must teach how to be a man.

I guess its time I learned how to be one.

The Great Textbook Debacle

Our books are being offered as a package deal from the on-campus bookstore, at the tune of nearly $1100 including tax. The package is offered as an all or nothing deal, and many students didn't take kindly to this. Especially when they took the book list and started shopping Amazon. Most managed to save about $300 over the package price, which sounds significant. Except...

Remember that PDA I've been complaining about having to buy? Well, we are required to have a proprietary software package including six different clinical companions, like a drug reference, a nursing dx reference, etc. Sounds way cool. Unfortunately, it's going to cost the self-shoppers $240 to get this software--it's included in the bookstore package price. So overall, they've saved about $60, and that's nothing to sneeze at. Except...

The bookstore package price also includes all our books in e-format. Very handy--you can do one search and the software will compile articles from all your books on that topic. So, say you search for renal failure secondary to diabetes mellitus: From the patho book it pulls the pathology, from pharm the pertinent drugs, from assessment how to assess, associated nursing dx's etc. Pretty cool. But I get that not everyone appreciates that, and many just want their paper books, and again, $60 is $60. Except...

It turns out this e-book package includes ALL our books for this semester...and the next semester...and the two after that. So if one were comfortable reading e-books, these could be the last text books to buy. Sounds like a great deal to me. Except...

Now an outside competitor to the on-campus bookstore is offering the exact same package, with a $100-off coupon. And free shipping on phone orders.

Now where did I put my phone...