Thursday, November 25, 2010

Pushing Onward... Hopefully Upward

Ok, I'm convinced that I am suffering from burnout. Nursing school so far has really pushed me to my breaking point, and I'm at least happy to report that I think my breaking point might be a bit further than I thought.

I think the weight of everything really has me down. My mom is sick and in constant need of a ride here, there, and everywhere. Operations, procedures, followups, denture places... She's a very needy woman at this point in time and thankfully, she has some good friends to help her where I can't. However, I still make every effort to take her where she needs to go when I have the time. What would have really helped here is a good marriage... a good partner to help me with my mother, however, my mom absolutely loathes my wife and won't even let her in the house.

Speaking of my marriage, it continues to suck worse than anything I've ever experienced. Basically, I've agreed for my son's sake to remain in the house until he is out of school in June, although I have a sinking suspicion that I'm needed primarily for bill-paying. Today was Thanksgiving and my wife let me sleep through it. When I woke up, everyone was leaving. Unfortunately, I am on a flip-flopped sleep schedule due to my overnight shifts as an LPN. She is very overbearing, controlling, and vindictive. She still checks my phone, my Facebook account, and pretty much everything else because she is convinced I am cheating, which I recognize as the sign of someone who is, in fact, cheating themselves. I think I'll have to make a special post with just how effed up I've allowed this situation to get, but it's a little more than I care to post right now, but let's just say there's little doubt about her extramarital relationships at this point.

School continues to be totally relentless. Somehow, I've managed to pass my drug calculation final with nine out of ten questions correct. If I pass this course, I will never have to take a drug calculation test again, thank God. Being the final drug calculation in the entire nursing program, this is the one that they pulled out all stops to try and trick you. All the critical care calculations, mcg/kg/min with x mg available in x mL, were on this one and it's thankfully a done deal. I also got back my third (out of four) skills quiz in which I passed with an 87%.

This small bit of good news doesn't mean I'm out of hot water though. I'm still carrying a 74.3% in theory which is failing. I have a fourth theory exam and a final exam to bring this up. If I can get my theory grade above a 75% with those two tests, I'm set.

In addition to this, I am taking Sociology and Speech. I will say this: the absolute piss-poor quality work I am turning into these classes amazes me that I continue to pass with low As and high Bs. I'm on the computer tonight to essentially stamp out the rest of what is due for my speech class. These, I feel, are unnecessary "gimme" credits that you'll get simply by showing up.

Work is going well. The twelve hour shifts are perfect for me. I can get 36 hours in three days, and then have off Monday through Thursday. The work itself is pretty hard though. I feel that my facility may have the world's worst paperwork system. It seems, at first glance, thoroughly disorganized. I've already been talked to about not signing a nursing note and not following up with a pain scale on the chart. No biggie, but I need to be really careful about it; the paperwork is long, involved, no-joke, and someone thoroughly is checking behind me.

During my days off I sleep. And I mean sleep. I've been getting between 9-11 hours of sleep a night: I just don't want to wake up. Maybe it's a touch of depression setting in based on all these concurrent situations occuring, maybe it's just my body attempting to recover sleep debt from all these weeks I've just been going sleep deprived. Who knows... but no matter how much I sleep, I'm still feeling run down and feeling totally ready for this class to be over: whatever the end outcome be that pass or fail.

Friday, November 12, 2010

Squashed

My little issue with the blood transfusion got squashed. I was not in trouble for the miscommunication, however, I did get a verbal warning for not reporting off. There were no points deducted off my grade, thankfully. I do agree with the verbal warning about failure to report and the instructor at least understood why I didn't think I had to. All in all, I'm happy it is resolved. I mut admit I did tell my instructor I was dropping the class if I got point deductions (which was totally a bluff) but hey, at this point, I'm ready to play dirty to get done.

Now that this is resolved, I really need a good grade on the next exam. I don't want to have to study furiously for a final to bring my grade above failing. The next exam is going to be easier than the last, which included 11 different diseases. This one is essentially just cancer and spinal cord injury. I've been telling people that to ensure passing I will do the following:

  1. Read all the chapter in the book pertaining to cancer.
  2. Make an outline from the book.
  3. Study note cards.
  4. Hang out with people who have cancer.
  5. Volunteer at the oncology ward.
  6. Attempt to give myself cancer to better understand it.

Seriously though, it's really freaking me out. However, in the first medical-surgical nursing class the final was fairly easy. I got a 95% on it. Hopefully, the final comprehensive exam is not quite in-depth as the chapter ones... this has been the general trend.

We lost another student yesterday. This class is starting to dwindle just like the first Nursing 101 class.

Also, tomorrow is the last day of my corporate job. I'm very excited to be changing careers, but a little nervous as well.

Until next time... I'm stressed to the max!

Thursday, November 11, 2010

Hot Water

Ok, so my whole nursing career has pretty much taken a turn for the worst. Here's what's happened so far...

First of all, I did majorly bomb that endocrine test. A 63% dropping my test average to 74.3%. That sucks, because I am technically failing; I need a decent grade on exam # 4 and the final exam to get through. However, that's doable and I'm not too worried. But wait, there's more and it gets even worse....

I was at clinical with the new clinical instructor (yes, same one that failed me on skills check). I'll give you a little background on how she's been teaching. First of all, she manages her time poorly. All of our meds and treatments end up being late, even though our clinical site policy leaves us an hour before up to an hour after for administration. In my opinion, there's no reason to be late. Second thing, she wants us to know everything before administering a drug. For example, she's asked me what someone's LFT is before administering 650mg of Tylenol. It drives me crazy. I understand where she is coming from, I really do, but there's just not enough time to do this: she has eight student and thus eight patients.

Well, the problem was this: my patient was due a blood transfusion. I was all excited, because as an LPN, I cannot perform this skill. I was getting real-world practice on an RN level skill. Well between all her questions and running from room to room, it took me 30 minutes to administer two pain pills and some eye drops. The blood had arrived from the blood bank, so there was a 30 minute time-limit to hang it. Since I can't even get a Tylenol administered in 30 minutes with this lady, obviously the staff nurse had to administer the blood so it didn't expire. If I wasn't in the room, I would have had no idea the blood was hung. I was then supposed to administer some low-dose lovenox as prophylaxis for DVTs. That was going to be late too so the staff nurse did it. The staff nurse did nearly everything because she, understandably, didn't have time to wait. Irritated that I had done virtually nothing all shift, I left the floor with the students to complete my paperwork.

However, I get called after clinical by the instructor. Apparently, I was supposed to do the q15 minute vital signs on this transfusion. No one asked me to; I guess it was just assumed I was. My instructor was nowhere to be found. I had no part in hanging the transfusion, no it's only natural that the person who hung it in this situation would take the v/s or at least delegate them to assistants.

Nope... totally my fault for not doing it. And I technically didn't report off to my nurse. I'm actually in trouble for not reporting that there was nothing to report. With all the stuff the staff nurse had to do, she should have reported off to me; I actually didn't do anything except an assessment, two pills, and some friggin' eye drops. The only reason I didn't formally report off was that the staff nurse was better informed of the patient's condition than I was because the tasks I was supposed to do had to get done by her so they weren't late.

What can I do? I dunno... I wrote a journal entry stating that I could improve my communication skills. Maybe I'll get off the hook with that. I just hope whatever gets done it doesn't boot me out of the program. Anyhow, I have to meet with her later so I'll post up what the resolution is.

Interested to know... what do you guys think? If you are a nurse, and you hung a transfusion, and you patient had a student, would you assume the student was going to take the q15m vitals without ever asking them? I can see where better communication on my side could have prevented this, definitely, however I don't feel the blame falls squarely on me because of two simple reasons:
  1. My instructor should have been present so I could have hung the blood. Crisis averted.
  2. The staff nurse should have asked me to check vitals. Crisis averted
This week has pretty much sucked... Until next time with more stressful and depressing news!

Tuesday, November 9, 2010

School sucks

Title says it all. I'm feeling pretty run down this week. I can't help but feel like I have some horrible disease that robs me of all my energy. I'm thinking non-Hodgkins lymphoma; nursing school and this disease seem to have the same set of signs and symptoms.

I took a theory test today that made me feel like someone punched me in the gut. The endocrine system. It was a real bear. Study, study, study... and then to get socked with a test this hard just sucks. A ton. I dunno if I even passed it. I'd have to fail pretty horribly to have my average go below the required 75% although after taking this exam I'm thinking that's a distinct possibility. I felt the same way about the liver/immune system test and I ended up with a 76% on it. In nursing school, a 76% is cause for celebration, so don't confuse that statement with me bitching.

Tons of diseases on this test. Hyperthyroidism, hypthyroidism, hyperparathyroidism, hypoparathyroidism, Addison's disease, Cushing's syndrome, diabetes insipidus, syndrome of inappropriate secretion of anti-diuretic hormone (SIADH), chronic renal failure, hyperglycemic hyperosmotic non-ketonic coma (HHNK), and diabetic ketoacidosis (DKA). Wow. That's a ton of diseases, syndromes, and other stuff that can go wrong. I'll guarantee you that each one of those was well represented on the test. I'll also guarantee that each one of those diseases messes with multiple lab values, electrolytes, and all sorts of other fun chemicals and I found it nearly impossible to memorize it all.

I got back my five page research paper on C.Difficile and I got a 90%. Would have had a 100% if I would have cited five sources instead of four. I'm such a dumb ass. I could have used that 10%!

So with a research paper with such a good grade why am I freaked out about these tests? Simple. Every project, paper, and care plan you do and get a good grade on (or a crappy grade) does not get counted in your grade until you average a 75% on the tests alone. You get a 76% final test average (all four unit exams plus the final) and all this other stuff gets calculated in pushing the majority of students to a 'B', even an 'A' if your test average is a bit higher.

I'm also taking two online classes to fulfill my general education requirements: speech and sociology. I hate to say it, but in comparison to Advanced Nursing, these classes are a complete and utter joke. Sociology I spend approximately 20 minutes on weekly and speech class I typically show up for once every two weeks, deliver a speech, and then leave. Does this adversely affect my grade? Hell yeah it does, but who cares... With minimal effort I can easily get a 'B' in these classes and at this point, I'm just not willing to put in the effort for an 'A'. Oh, and even more great news; I'm supposed to deliver a speech tomorrow, but I had to call out.

I found out two days ago my mom needs to get a colonoscopy in the morning. What's this mean? No time tomorrow for my care plan, so I gotta do it all tonight, get up early, and drive 50 miles away to take my mom to and from her colonscopy, and then drive another 50 miles back to sit in clinical with a patient who will more than likely be discharged by the time I get there. Not to mention she had a gallbladder removal on Thursday that totally jacked up my schedule.

This sucks. It just does. There's so much I gotta do and tons of shitty time limitations. Not to mention I need 13 online tests done and a teaching project. Sometimes I wish I could just take a time-out and continue with my education a little later.

There's a problem with that though. The way I figure it, there will always be some family emergency, some function with my son, or some other thing that's always going to be getting in the way. Might as well get it done now because the "catastrophes" that always seem to happen always seem to happen during nursing school. Not just during nursing school... always during critical weeks. I sometimes think I was born with shitty luck.

Tomorrow is my clinical with the instructor that didn't pass me on skills check. She's very detail oriented and I'm finding that my care plans need to really be up to par for her. I feel like they've been fairly lenient on us this semester (until now) because I really only have two or three more care plans for the entire RN program.

Until I write again, I'm signing off exhausted and overwhelmed... And not even thinking about a Bachelor's (for at least another six months after graduation, that is.)

Saturday, November 6, 2010

Anticlimactic

Talk about anticlimactic... When I got my first LPN paycheck, seems that the HR director forgot to put in my new pay rate, and, you guessed it, I was paid as a nursing assistant. I also might add that my LPN pay rate is more than double a nursing assistant rate, even without any job experience.

The instructor that flunked me on my skills check for a ridiculous reason is also being overly critical, in my opinion, of my concept maps. I literally have two nursing care plans before I'm completely done with them altogether for the RN year, and all of a sudden there's issues with them. The care plans and concept maps have been fine for the previous 15 months, however, this new instructor is finding issues with them, which is pretty much pissing me off even more than the skills check issue. I mean the first part of this semester I turned my work in to the primary instructor who has 30+ years of experience and has a Ph.D. This girl is a newly graduated clinical educator. I also am doing very well in class; nearly 3/4 of the class got academic warnings at the mid-semester point and I did not. Why is she giving me (and others) such a hard time? Couldn't tell you.