Oh, but this is all just review for you, isn't it?

I kind of love and kind of hate that some of my teachers have so much confidence in me sometimes, or assume that the content is easy for me. They think, oh, she's got a biology degree already, this content is effortless for her!

But stop and think about that for a minute. How many undergraduate biology courses do you know of where they go over acute interventions for increased intracranial pressure? How about the specifics of traction setups? Or different methods of modifying the bowel after a portion of it has been removed?

Yes, I have probably a better understanding of some of the anatomy and physiology of mammals than some of my classmates. And I'm a good critical thinker. But I'm still working HARD!!!

My training in marine biology is not so much helping me with patient care, I promise. If anything, the greatest benefit of having a couple degrees behind me already is that I know how to be a good student; I know how to study well, and I'm not as shy about asking the questions I need to ask.

At least two tests per week...

I both love and hate that there are tests every week in nursing school. I love it, because it means that you can't ever get too, too terribly behind. I hate it because it's exhausting, the hours of preparation.

For one thing, now that I'm in second year, we have clinicals on Monday and Tuesday, and classroom work on Wednesday and Thursday (labs on Friday). So after 2 days of clinical, which can be sort of high-stress, what with being watched and judged and trying to find what you need and keep everything running smoothly, when it would be nice to go home and take a nice nap, instead you have to prep for a test.

It's all got to be about staying ahead of things, I suppose. I can't plan on using Tuesday nights to study, because I know at this point that I will be pretty darn exhausted. So I've got to get that test prep done by Sunday at the latest for  a Wednesday test.

The upside is that my instructors this year all write a decent test, and are reasonable and logical, and willing to discuss questions about the exam in a non-threatened way :)

One thing that's happening this year that didn't happen much last year, is frequent verbal references to the upcoming NCLEX. Like, "You don't have to know the types of traction in detail for my exam, but you may need to know them for the NCLEX, especially these 3." Or, "A good test-taking hint is that if it doesn't sound familiar from something we've just recently talked about in class, it's probably not the right answer, although that approach won't get you anywhere on the NCLEX."

Should I be scared of the NCLEX? I know it's very comprehensive, which is intimidating, but I think I'll be okay.

A study tool to share

This is not everyone's style of course, but I've found it works really well for me. I've been using an electronic flashcard app (I used gflash but there are many out there) to translate every factoid from my nursing school powerpoints into a question and answer.

I make a table up of all these Q&A's in google docs, then import into gflash, use that as my drill tool and before long I've got the lecture memorized. It's easier for me than making up index card flashcards because I'm a fast typist. Usually by the time I've typed up all my flashcards from a lecture (about 60-100 questions per 2 hour lecture) I know at least 50% of the material.

Gflash presents you with all the questions to get your baseline, then reshuffles and focuses on the ones you missed the first time around, mixing in a few that you already knew. It keeps doing that until you get them all right.

For me, the repitition, and the in-my-head recitation of drilling these electronic flashcards does the trick. And in order to write a meaningful question on my flashcard, I have to have understood the material.

In my program they give us weekly "objectives" that basically summarize what we are supposed to get out of the content from that week. Sometimes all of the objectives are addressed in lecture, and others you really have to dive into the books to get the full picture. I sometimes translate the content from these objectives into flashcards too, if it is really information dense.

This all takes time but it seems to be a guaranteed "A" unless the teacher is intentionally writing nasty questions (we had one of those teachers last spring).

The other plus is, when midterms or finals come around, you've got a whole database of flashcards to run through rather than going back and trying to piece together concepts from the start again.

There are other tools of course. Published study guides that go with the textbooks we use, and online references and practice tests made by the publisher. I've found these things only moderately helpful in actually doing well in the class.

In anatomy class, I found that making powerpoint quiz files (structure on first slide, labels on second slide) was a really effective tool.

This all may be obvious and natural to some, but the last time I was an undergrad none of these tools were around! Now I can have thousands of flashcards on my ipod and organization is a breeze.

I've also found that it is very soothing for me, the morning of a test, to have the feedback of an app that's telling me I know 100% of the material, rather than flipping back and forth between notes and thinking, "gosh, I hope I remember this all, I have no idea how much has stuck."

First few days of RN program

Monday: Arrive at 8am, sit through 6 1/2 hours of mostly lecture. Ask lots of questions and feel little timid about asking them because I don't know my teachers and classmates yet, not really. Feel completely awed by the first two professors I meet. Go to work immediately after school until 10:30pm, leave about an hour before shift end with my med tech partner's agreement, and crash HARD.

Tuesday: Arrive at 9am having slept like a brick the night before. Everyone is sitting in the same seats as yesterday. There are about 20 chapters of reading I was supposed to have done just for the first week, out of 16 or so different books, and feeling pretty overwhelmed by the quantity of information coming our way and being behind on the reading, but yet also thankful that I'm able to follow everything the teacher is saying so far, and that my most recent job has given me a lot of valuable experience that will help me in this first semester. Almost start crying during the portion of a lecture on therapeutic communication because I've just had a somewhat traumatic experience (for both me and the resident) two nights ago at work that is still lingering in my mind). Even more awed by the teachers today than the ones from yesterday. Especially one of them. I contemplate the fact that I never really admired my science professors as much as I do these nurses I've just barely met. Knowledgeable, wise, and so very intelligent, both academically and emotionally/socially.

Get to go home early that afternoon, around 1:30. Need to tune my brain out for a bit, so put on some TV and end up watching it longer than intended just because it feels so good to let go of that brain overload feeling for a few hours.

Get myself back on track, do a review of some math that's going to be on a test tomorrow (already!) to make sure I remember how roman numerals work and can do all types of fraction math with speed, briefly consider watching the videos about basic bedside care that I'm supposed to watch for tomorrow's skills day, but decide sleep is more important. Then have a fitful night's sleep.

Wednesday: Arrive on campus at 7:30am to the skills lab for an all day basic care activity nicknamed "CNA in a day". Realize that although I have been working in an RCFE (residential care facility for the elderly) for the last 8 months, I don't have a lot of the skills that are considered basic in a long term care facility, like giving a bed bath, sitting a bed bound patient on a commode, taking blood pressures the old fashioned way, brushing a patient's teeth for them or shaving their face, etc.

Tomorrow, Thursday, I'll be going to my first clinical site for orientation with my clinical instructor. My clinical instructor just got hired two days ago, and I'm a little wary of that fact. She will be shadowing another more experienced instructor while teaching us. She seems nice enough so far though.

Passed my first phlebotomy competency!!

I didn't know we were going to be doing a skills check-off tonight, but we did! I was apprehensive about it, because I hadn't tried doing the procedure without looking at the page before tonight, but I practiced a couple times (and let someone practice on me a couple times), and then went for it, and it was fine! She said I was very thorough and did a great job.

My partner, however, barely passed. She got out all her materials, and was going to swab my finger with alcohol, and I didn't want to say anything, but she didn't have any gloves on yet, and that's IMPORTANT with a capital I; our observer apologized that she should have caught it too. Then, after she used the lancet on my finger, she went straight to collecting blood into the tube instead of wiping away the first drop. THEN she didn't know the last steps about what to write on the requisition and double checking the spelling of my name. She was probably just nervous, but she hadn't done it well when it was just the two of us and no observer either.

The person checking us off made her go through it orally a few more times without the actual stick, and she still wasn't getting it right without some serious coaching, but finally the lady passed her. I couldn't believe it. I wouldn't have passed her. We get a second try after all, if we don't get it right the first time.

I really, really, REALLY hope I can do my externship at the hospital that I volunteer at. That would be ideal.

Finger Stick Blood Collection

Tonight was our first skills portion of the phlebotomy class I'm taking. Okay, well, I guess technically we already had one, but that was just how to wash our hands correctly :)

We partnered up, 8 at a time, and went through the procedure of doing a blood collection from a lancet poke in the finger tip, collecting to a capillary tube. I got to practice twice, on two different people. Both said I did a very good job. I was a little nervous going into it (both on the patient side and on the phlebotomist side) but it went pretty smoothly. I think the part I will need to practice most for is not the actual hands on stuff but the best things to say to the patient and being sure to come across warmly and with confidence rather than nervous and new at this. But tonight went well.

I can see that my worlds are starting to collide a bit. The girl I carpool with to phlebotomy class is neighbors with the woman who is out on maternity leave form my new work. So my job is going to know eventually that I am taking a phlebotomy class. Which means that I am thinking of moving on. But maybe that's not necessarily a bad thing. Maybe they will offer me a full time gig if they are keeping in mind that I have other options open.

Medical Terminology Course

After my human anatomy and physiology prerequisite courses were done, I wasn't planning on taking any more classes until nursing school started, that is, unless I wasn't able to find work, and as a back up I planned to sign up for phlebotomy and medical assisting for Fall semester.

However, spring term ended, I still haven't found work, and the tutoring center called me to ask if I wanted to keep working for the summer. They said I needed to be enrolled in at least 1 unit to keep working through the summer. A couple of weeks later, after the 6 week summer term had already started, they told me they had made a mistake, that as long as I had been a student in spring it was okay to keep working in summer without having a course.

By that time I had already signed up and taken the first test for Medical Terminology, an online course offered through the nursing department. It is 3 units, and let me tell you, it is probably the easiest class I've ever experienced. With the combination of my background in biology and having studied some languages, and then the fact that it's an online course, I can work at my own pace and it's basically open book, I really can't imagine not doing well.

I almost dropped it when I found out I didn't need it for my tutoring job, but I had already paid the enrollment fee, and I thought maybe it could help me study for the TEAS, and perhaps be a good resume builder, maybe land me a job as a medical transcriber or something.

I probably should spend a little more time on it, rather than whooshing through it breakneck speed, so that the words that have been new to me actually stick in the old 'noggin.

What now?

I had my first week of Spring semester last week. I am taking Human Physiology, and Psychology. I am not sure quite how it worked out but in my first B.S., I think it was my microbiology class that ended up fulfilling whatever requirement it was that people usually take Psych for in undergrad.

It turns out that the lecturer I am going to have this term for Physiology is the same one I had last term for Anatomy. However, she is using all of the same materials for the class from the woman who usually teaches it, and that teacher, I can tell is ultra organized. So that will help. I wasn't able to get back into the Psychology section I dropped for the new job that didn't work out (see last post) but I was able to add a different section for Thursday nights, 7-10pm. It uses the same book, which is a relief, and seems like it will be extremely, extremely easy.

I got my job back at the campus tutoring center, and adjusted my schedule so that I will only be working on Tuesday through Thursday, the same days I am on campus anyway for class. I am hoping because I will be starting at the beginning of the semester this time instead of part way through, and I know more what to expect, I can really get a good group of students established right off who will be consistent. 20 hours per week x 9 dollars an hour = 180 per week, or 720 minus taxes per month, but that is only if everyone shows up and my schedule is full.

My confidence in myself kind of took a hit with the whole fiasco at my last job. I know I need to get a second job but now I am not sure what to do. It would be nice to get something in health care... two possibilities there would be:

(a) work in a nursing home doing elder care
(b) finish my cardiac arrhythmia training and try for a tele monitor job at a local hospital

And another possibility I am considering now, mostly because they have medical benefits for part-timers is:

(a) Starbucks barista

I have to say that the Starbucks thing is kind of appealing. I could work my 3 days at the tutoring center, 3 days at the coffee shop, and end up with enough income to not be going in the hole every month and also be able to stop paying COBRA health insurance after 3 months. It might be kind of tiring to work 6 days per week but maybe this would be the best solution.

If I was able to get a tele monitor job, their shifts are 12 hours, and 3 shifts is considered full time. I don't know how flexible they might be about scheduling around a school schedule, or that might be a good possibility. The main thing holding me back from that is my confidence level. What if I'm not good at it, and what if I make a bad impression at one of the two local hospitals, and then once I'm done with nursing school and looking for jobs I won't feel comfortable going back? Maybe that's being ridiculous.

If I went for the tutoring + starbucks option, I doubt I would be able to fit in 200 hours of health care work experience before I turn in my nursing school application. I don't know.

Elder care could also be fine, it's just a matter of finding a job, as none are posted right now. Plus, I'm pretty sure they wouldn't throw in medical benefits for a part-timer so that would mean quitting my tutoring job and stuff or just doing part time and continuing on cobra still.

Lots to think about.

One bright ray of hope in all the gray: I ended up with an A (not even a minus) in Anatomy for last semester. I found out earlier this week but forgot to post it in all the chaos. That will help my application. I was right on the border at the end of the term, so I must have done pretty well on the final.

Winding down Semester 1

The other night I was doing some calculations. For the ASN program I'm planning to apply for, they give you a certain # of points if you already have a degree, a certain # if you have career or volunteer experience in the health professions, a certain # depending on your score on the TEAS test, etc. And different categories of points based on your grades in pre-nursing science classes. These classes are Microbiology, Human Anatomy and Human Physiology.

I took micro about 10 years ago and got a B at the time. In Anatomy I'm right on the edge of an A/B right now, so that will hopefully be an A-. The way they set it up, if you had a 4.0 overall from these classes you would get 40 points, a 3.5-4.0 35 points, a 3.0-3.5 30 points... something like that. The way it works out, given I got a B in micro, if I get a B in Anatomy, there is really no point in me striving for the A in Phys (in terms of the application!) because I would already be doomed to the 3.0-3.5 bracket. Yes, I may be over thinking this a bit.

I took my last lab oral at the end of last week and got a 33/35. It was on the urogenital system. One of the points I missed was for not recognizing podocytes and slits on a model of the glomerulus of the kidney; I would have recognized them in a different context but oh well; that's still a 94%.

For the final, we are going to have 50 projection slides to look at and identify structures from the cumulative material this semester, and the remaining 100 multiple choice questions are going to be from the last segment of material: digestive, urinary and reproductive systems. I think I have a pretty good chance of bumping it up to the A with that final.

A job I applied for to work at the local blood bank as a donor care specialist closed 2 days go, so I'm hoping they will contact me for an interview next week. It would be full time work, which could be hectic with my schedule next semester, but really the only class I *have* to take next semester is the physiology, so I think it would be doable. Here's hoping.

I'm going to spend this afternoon studying for my anatomy final. I need to review the labs from this section, scan through the book for terms and diseases, work on the cumulative slide section, and review the lecture slides. I am kind of glad that my anatomy lecturer is not going to be my physiology lecturer.