Oops, I got busy and didn't post.

Before I started this blog, I noticed a pattern in nursing school blogs where they start out strong and then dwindle over time, eventually completely disappearing. I wasn't gonna be like that. But holy cow nursing school is busy. You've got coursework and lab time and clinical, and a job to pay for school, and study hours. Eventually there's no time left to do anything but collapse in an exhausted heap at the end of the day. I do love it. It's going well, and I'll be done with the RN program in about 9 months. Will do a few catch up posts today.

Bravely exposing the truth, or, just a plain rat.

Since I've switched to working the PM instead of AM shift, I've now been scheduled almost every work day with my "bestie" at work. We never had much in common but she was fun to hang out with...until we started working together ALL THE TIME. And being in such close proximity with her, I realized what a bad employee she was, and when it came down to it, a bad friend. Spending half the shift texting on her phone, talking about her latest sexual exploits while we were both pouring meds, leaving pills behind with residents rather than watch them take them (an important safety measure when you're working with the elderly), and generally not taking anything very seriously.

This friend has been going through a lot of personal drama lately, and distancing herself from it by flinging headlong into a new relationship. Soon, she was leaving early nearly every shift to go be with that guy. She knew it irritated me, and she started lying about the reasons for leaving early: when she left it would be, "I want to get home so I can spend some time on the phone with my son," and then the next day it would be, "guess what I tried in bed with so-n-so last night." I let her know the dishonesty bothered me, and that I felt taken advantage of when she cut out early all the time without doing her share of the work. She knows what that's like after all, she used to complain about another of our coworkers doing it to her all the time. We came to a sort of truce that I would try not to get bent out of shape with her leaving early so much if she would agree to be the one to stay most of the time when school started for me and I needed to cut out and go sleep or study.

Then I noticed that she was making some pretty serious med errors. Not giving pills that were supposed to be given. Continually skipping the full narcotics sign out process. Leaving pills in residents' rooms as a rule, rather than an exception. Signing out treatments without regard to whether she'd done them or not. At this point my irritation gave way to concern for the residents. I had covered for her once, when I knew she had omitted an anxiety pill from a resident's night time pour. I felt sick about it afterward, and it still bothers me. Part of my job is to check through the records and audit where mistakes are happening. If I'm going to be taken seriously, and seen as fair, I need to do that process without regard to whose mistake I'm looking at. I need to be unbiased.

Then one night, she gave a resident double the dose of a narcotic he takes to help him sleep. I understood why she made the error; the dosage of the pill had changed, and she hadn't been paying close enough attention to catch that change; a week ago giving two of those pills (of a lower dose) would have been correct. She just wasn't paying attention anymore. That particular resident is younger, has problems but still has a sharp mind. He asked her why there was an extra pill that night, and she blew him off. Said to go ahead and take them, and she'd research it and come back later. She never came back. I don't know if she realized she'd made a mistake and didn't want to deal with it or just forgot; she was in a big hurry to get out the door that night, and left about 2 1/2 hours before the end of shift.

The resident came to me and explained what happened. I looked at the records and the pills that were left in the packages and knew right away what she'd done. At that point there was no question in my mind. I had to call our supervisor. I had to step forward and put the mistake out in the open. I confirmed the resident's suspicions that he'd been given the wrong dose, and let him know I was going to call my supervisor for advice. He said he had the supervisor's phone number in his cell, so we could just call together, right then, and that's what we did. We explained to my boss what had happened together. I think it helped re-establish some trust with the resident that not all of us med techs are flippant, irresponsible jackasses.

My frenemy was put on suspension for a week, then fired. At one point the managers were talking about the possibility of letting her stay on as a caregiver, even though they didn't want her to handle medications anymore. I don't know if they gave her that option in the end or not. The resident is fine.

My coworkers are treating me differently now. One of them, one I really like, has expressed in so many words that he thinks I should have covered for her, and is treating me coldly now when he used to be very friendly. Some are labeling me as the backstabbing bitch. Most aren't saying anything to me about the whole thing, but I'm sure they're talking about it amongst themselves. A couple have let me know, in their quiet way, that they agree with my actions.

Update on first two weeks of nursing school

The first two weeks have been a little exhausting, but I think without the stress of everything that has been going on at my JOB lately I wouldn't be so overwhelmed. As it is though, managing both, I'm tired all of the time and in the last couple days have been pounded with a cold that stripped me of any remaining energy I had.

First of all, a word of advice for anyone reading this who is about to start nursing school: Do the first week's reading before school starts. Really. Even if you mostly learn by lecture, and have always done things differently in the past, just take my word for it. You'll be grateful you did.

I however, didn't, am at the end of week 2 and still not caught up. Thankfully I have only one day of class during the coming week and should be able to get my act together during that time.

I have had my first two clinical days now. It was in a long term care facility, and my assigned person to take care of was a very light load. She didn't need much assistance and I understood the health problems she had very well. If anything I think she was over-diagnosed, perhaps for funding reasons to make her able to stay there. They chart to highest level of care at the facility I was assigned to, which makes sense if you are trying to staff and run a place like that. I was struck by how meager the activity offerings are at such a place, which is privately owned but takes a lot of medicare people and is considered a medical facility, comparing it with my work which is mostly private pay and non-medical.

Last night, after my first two days of clinical, I had strange dreams about alien creatures that crawl up your anus and eat your rectum. Also, after having a morning phone call and then falling back asleep, dreamed of going through closets and closets full of someone's decades old hoarded clothing with my sister.

We've had two tests/quizzes so far. The first was about 60 questions, and you had to have 100% to pass it. It was basic math...fractions, decimals, rounding, etc. I caught one mistake on my second go through but it was 100% by the time I turned it in. Without knowing the actual figures, just listening to what my classmates are saying, about 1/3 will have to retake it, and the faculty planned for that. It's all too easy to miss one if your nervous. The second quiz was also on math, but dealt with conversions specifically related to medication. The main thing I didn't know for that was the old system of grains and drams. I studied up, was completely confident before and during the test, but somehow only got an 8/10. I wonder what I did wrong, but as one classmate put it, "it was probably something stupid and not worth our limited time to go back and track down the teacher about it."

Our exam next week is also in the pharmacology/math/medical data class. Between now (Friday afternoon) and the test (Tuesday morning) I'm going to focus mostly on catching up on reading/studying for that class, and some on prepping my research for my next clinical client. Oh, and the whole getting better from this miserable cold thing, I need to spend some time on that too. I'm also scheduled to work Saturday, Sunday, Monday.

Next post, immediately to follow, will be about everything that has been going down at my job.

One scary thing...

At the end of our all day skills day, our teachers sat the whole group down for a "serious talk" about the policies of the program. Most of it seemed pretty reasonable and manageable, like absence and tardy policies, etc. But many of us jumped when they outlined the policy on clinical practice plans.

They went into this long thing about how they are meant to help, not hurt. They will make us better nurses. Oh, I guess I should explain what it is first. If your clinical instructor notices that you are doing something wrong while out in a care setting, they will sit you down and you have to write up a plan together to work on making it better and eliminating the problem. That all sounds great. Maybe a little threatening just in that it's a criticism, but not a HUGE deal. And they say most of us will get one at some point, and probably more than one. Okay. I can cope with that. But then they say, oh, and by the way, every time you get one your grade drops by half a grade. So, say, if I have an A-, but then they notice that I forgot to wash my hands once in a situation where I should have, then B+. Ouch.

Makes me a little more nervous about going into the clinical arena with the instructor.

I've noticed in myself that in the first few days of school, I've been feeling kind of insecure, kind of shy. A little overwhelmed by everyone seeming to know my name and I haven't quite picked up theirs yet. A little self conscious when I ask a question that feels a little out of my league. Happy but suspicious that there's some negative connotation behind it when one of the other students teases me that I'm their class president (elections have not been held, and yeah, I've thought about it, but...).

Deep breaths. No biggy. This is going to be stretching my definition of who I am, but in good ways.

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.

Should I know already?

I have 2 weeks to go until nursing school starts, and I have to say that lately I've been feeling self conscious when people ask me what *kind* of nurse I want to be, and I really don't have an answer.

My plan has just been to get a wide variety of experiences during the clinical rotations that are a part of my school program, and at graduation time, go with my gut, or alternatively, where the jobs are. I don't feel like I know enough yet to be able to say, "OH, well, I'm going to be a pediatric nurse, definitely."

I currently work with seniors, and I like them, and they me, but I don't know that that's where I want to specialize long term. I could see myself moving around a lot within the nursing field to keep learning and growing. Or working on a unit that sees a really wide variety of patients. Or, hey, maybe I'll find myself just completely enchanted with something I have no experience with yet.

I have a friend who is a surgical nurse, and she loves it. A friend of that friend, also a surgical nurse, told me that she liked it because the patients are mostly asleep! Oh, and it pays well. But you have to be very, very good at getting along with doctors.

I am pretty sure that I do not want to work in a prison, or the state mental hospital. I want to be able to feel safe with my patients, for the post part.

I was reminded of my indecision again when one of the school staff was talking about helping us write our personal statements. And I was thinking, gosh, I bet they want you to say what area of nursing you are most interested in there, too.

In a scholarship application I recently turned in, I'll admit I catered to what I thought the scholarship provider would want me to say. It was a conglomerate that owns several senior care centers in the community. I expressed in my essay answers that I enjoyed working with seniors, and hoped to continue that. That's true, in a sense, but I don't know that I want that to be my entire job.

So, for now, the jury's out. One of the things that appealed to me when I was first starting to look into nursing as a career was that once you were "in the club" with that RN, you had A LOT of options, and you could move around, too, you weren't stuck where you started. Am I just rationalizing my indecision?

Betrayed by the financial aid office!

I found out today at a pre-school year test-taking skills seminar that I could have put in an application for a whole bunch of school based scholarships that I was aware of, but had been told by the financial aid office I was ineligible for due to already having a degree. I feel so betrayed. I would be eligible up the wahoo based on financial need as well as past educational performance. DARN. Next year I'll know better.