Snow

I made a quick video for all you people in Portland that think you've been having blizzards. I'm not sure if the sound will work, but if it doesn't I didn't say anything interesting anyway. All the snow that you see fell in an 8 hour period the day before.



In other news, I go home tomorrow! Yay! I just hope the weather allows it...

Exhaustion and headaches

I've found a couple of different types of exhaustion in the past few weeks. There was the pre-Thanksgiving exhaustion that involved a complete lack of motivation to do anything at all. This included schoolwork, clinicals, exercise, cleaning, laundry, shopping, interacting with people, or any other activity that didn't involve eating or my computer. Thankfully I'm done with that now.

Then there was the post-Thanksgiving exhaustion, which involved a flight being canceled and getting almost no sleep while trying to figure out how to travel from Toronto to Rochester in the shortest period of time. Thankfully that is now over with as well.

Today I got another kind of exhaustion. This kind comes from having an 8 hour clinical day in which only 30 minutes is spent off of my feet (that was lunch) and then choosing to spend an hour in the gym. Granted an hour is not a long time, but my workouts are fairly streamlined by now and I can do a good job of beating my legs into a pulp in an hour. 25 minutes of hard intervals on an elliptical, followed by leg presses, dead lifts, squats, and extensions. Add in warm up and stretching time, and that takes an hour. I walked home with a shuffling gait that you usually see on Parkinson's patients. But when I got home, I wasn't sleepy, just exhausted. So I showered, ate, and sat around for a while avoiding homework. Which is not all that different than my usual evenings, but I did it with much less energy.

At some point this evening my headache started. I've been getting more of these headaches in the past few months than ever before. If I don't get rid of them quickly they turn into migraines, which is a very bad thing. Being the clever nursing student that I am, I tried to find a pattern to the headaches. Lo and behold, I did. They always happened after I work out. Not after every workout, but every headache that feels like this comes after a workout. So, still being a clever nursing student, I turn to Google. Google (and the Mayo Clinic) informs me that exercise-induced headaches are very common among people that are prone to migraines. I honestly can't believe that this never occurred to me before. Exercise dilates blood vessels, migraines are caused by excess blood vessel dilation in the brain... duh. So, I know now to expect a headache after a hard workout, and that I can even prevent a headache by taking an NSAID pre- or immediately post-workout. Unfortunately, NSAIDs slow muscle healing and recovery... hmmm... Luckily, Google and the Mayo Clinic also informed me that the headaches should go away, or at least lessen, if exercise is done regularly. Yet another incentive for me to get myself to the gym.

In unrelated news, my clinical instructor adores me. This is very good because I will be using her for recommendation letters in the near future. At one point today, after telling me how awesome I am at this nursing thing, she asked me what I used to do. I told her that I did bench research in a neuromuscular development lab. She took a moment to absorb this, with an incredulous look on her face, and said, "I am so glad that you're not doing that any more." I agree with her completely.

Snow

There was an inch of snow on the ground when I woke up this morning. It stuck around all day, and more is going to be coming down throughout the week. Let winter begin.

How did I respond to this snow? First with a lot of impolite words, mostly under my breath, and then by turning my singlespeed bike into a fixed gear. See, I'm not going to ride my race bike in the snow because not only would it be dangerous on skinny slick tires, but I'd end up ruining the bike once they start putting down salt and I start crashing because of ice. So, in order to continue riding as often as possible this winter, I need to ride my steel-framed clunky commuter bike. But that's no fun. At least until now.

A fixed gear bike does not let you coast. Any time the wheels are turning the pedals turn too. It's how all bikes used to be before the invention of the freewheel. The benefits of riding a fixed gear bike are that you get stronger (zero rest = strength + endurance), pedaling technique improves, and you learn how to pedal at a really high cadence, because that's just what happens when you going to go downhill. And, it's a whole lot of fun, mostly because it's a new challenge. The challenge is simple, if you attempt to stop pedaling while the bike is moving forward you do one of two things: If you're in control you skid to a stop and feel lucky, if you're out of control the bike flips you over the handlebars. I rode it around the block a couple times today, but it was getting dark fast, so I'll need to do a real test ride as soon as I get the chance. With luck I won't be doing any flips.

In other news, school is still insane, but I'm still enjoying it. I will be observing in the operating room all day tomorrow, which I'm really looking forward to. I have no idea what kind of surgery I'll be able to see, or if I'll see multiple, that will be decided when I show up.

My housemate, Jess, and I spent an entire day baking this weekend. We're coming up with winter survival plans and a lot of them involve food. This plan was specifically to get a weird food at the public market every week and make something with it. This weekend was persimmons. I'd never had one before, but it turns out they're really delicious. We made persimmon tarts and persimmon cookies. And then just for fun we made some hummus. Next week I think we're going to try making bread, and something with our mystery market food. This is a fun game.

A sorta, maybe good day

I think today was a good day in clinical. Why? Because I was busy pretty much the entire time and I felt like I really did something good for my patient. Unfortunately, the situation that allowed me to be busy and contribute was my patient having a stroke. Does that make today a bad day? It was definitely bad for him, and it was very stressful for me, but I got to learn a lot and while we were rushing down to get a CT scan, I was the one providing the neurology docs with his pertinent history and current medications. I was capable of answering all of their questions, I explained what was going on to my patient, I worked with the team of nurses and docs to get him where he needed to be as quickly as possible. In that sense it was a very good day.

I guess I'm feeling a little bit guilty for being happy with what happened today. I'm glad I got the chance to help with an emergency situation, but I shouldn't be too glad because it means that my patient's health is declining. On top of that, today was my last day on 7-14 and I will probably never find out what happens with him. That part of school bothers me a lot. I want to see my patients' outcomes, I want to know whether they will be okay. Sadly, there is nothing I can do to change that part of the system.

My major frustration today was with the neurology resident. After forcing my patient to get up out of bed, despite being warned that he was very unsteady and barely able to walk, he left me there with a medical student and my patient sort of half sitting on the edge of the bed. This was incredibly unsafe for several reasons. First, my patient weighs about 350lbs. If he falls on the floor (which has happened) it takes about 6 people to lift him back up. Second, he is very weak at the best of times and understandably exhausted from everything he was put through that afternoon, he barely had the strength to help us move him back to bed. So, this doctor finished his exam and just walked away, leaving me and a med student with an incredibly large, exhausted, and weak man who we can barely keep from falling onto the floor. Thank god my clinical instructor was walking by the room and grabbed a few people to help us. I understand that docs are busy and very focused on their specialty and figuring out what's wrong, but the primary focus of every health care worker in the hospital should be patient safety. There is no excuse for what he did.

I have had other bad experiences with providers (doctors and nurse practitioners) lately. They get too focused on diagnoses and orders and forget about the basics, like safety and comfort. I do not expect to ever see a doc giving a patient a bath, but I do expect them to make sure that if they cause a huge mess (such as a patient vomiting all over himself during an NG tube insertion) that the nurses and techs cleaning up that patient are okay and have all the resources and information they need before the doc leaves the room. That way we don't have to go harass the doc while he's writing his orders or seeing another patient.

All of that being said, I am going to miss 7-14. It was a good floor with (mostly) good staff. I've heard very contrasting reports of what my next floor will be like, so I'm keeping my fingers crossed.

I must be procrastinating or bored

Yeah, yeah, I'm bad at updating. At least I'm not as bad as some people I could name... ;)

It came as quite a shock when I realized that it's officially November now. Halloween is over, I get to vote on Tuesday, as usual I will feel weird without a poppy on the 11th, and Thanksgiving will arrive before I even get a chance to breathe.

I'm sick right now. I started feeling yucky on Monday, but nothing too bad, just achy and tired. Then on Wednesday I was at clinical in a patient's room and I suddenly became very dizzy, nauseous, and felt like I was going to black out. Luckily, I was surrounded by nurses and they sat me down, got me some food and juice, and refused to let me get up for almost an hour. I was feeling pretty much okay after I'd eaten a little and rested, but my instructor let me take the rest of the day off, for which I am grateful. I went home thinking that maybe I'll catch up on some work, but ended up just falling asleep for 3 hours.

When I woke up, I had just had time to get dressed and get bored enough to call home to tell all about my fainting fit when a prospective medical student knocked on my door. Jordan had volunteered to put him up for a couple of nights while he interviewed at the med school. He was a nice guy, very geeky, from MIT, and a former Google intern. He was clearly not a medical student yet because he still had this bright-eyed optimism and excessive amount of energy. Jordan and I tried not to dampen his spirits too much with reality during the dinner conversation. Poor guy, he thinks he knows what's coming but he really has no idea.

Jordan and I had an interesting conversation about med school applicants after our prospie left. Apparently current students get to interview applicants and their comments are pretty highly valued during the admissions process. Jordan said that the majority of students have a canned answer for, "Why do you want to be a doctor?" which I would expect. The surprising thing is that if you rephrase the question to include a little more reality, such as, "You are volunteering to give up the next 8-10 years of your life to intense school, no sleep, and harder work than you've ever experienced. What makes that sacrifice worthwhile for you?" they have no idea what to say. It makes me wonder whether these people really know how brutal and pointless a lot of medical school can be, or if they were just not aware or willing to consider other options in health care.

I got to skip my second clinical day on Thursday in lieu of shadowing a home health nurse around on Friday. Thursday was instead spent in a combination of resting and shopping. I got myself a Zipcar and did all the things that I had been avoiding because I didn't have time. I even bought myself some snow boots and a tuque. Bring it on, winter, I'm ready for you. I also stocked up on soup to keep my cold-ridden self going.

Friday was my home health shadow. Sarah was very kind and drove me out to the agency office because I was in no shape to bike. I then followed my nurse around as sh met with a couple of little old ladies with minor wounds and caught up on some documentation. She couldn't get in touch with her other patients for the day, so just dropped me off at home around 1pm. I called Sarah to let her know she wouldn't need to give me a ride back home, and she asked me to come over and give costume help. She had a truly fabulous big floppy hat with ribbons and flowers on it and a long shiny purple dress that matched perfectly. I did what little I could to help her curl her hair in big bouncy ringlets and then went home to sleep for a while. At about 5:30 we got our first trick-or-treaters, Sarah and co. as well as another family with a pair of 2 year old blond twin boys. More trick-or-treaters followed pretty quickly after that, and we sadly ran out of candy before they stopped. I hadn't expected so many, but it turns out that a lot of kids get driven in to our neighborhood from the more dangerous areas of town. A lot of them didn't have costumes and were using their backpacks for bags. My guess is that was for financial reasons rather than the usual "we're too cool to get dressed up" reasons.

After candy dispensing, I started to get dressed to go to a Halloween party hosted by some classmates. I've stopped attempting to go to most of the class parties because they have devolved into loud and obnoxious groups of very drunk people, but this one was hosted by a different house and was advertised as being pretty quiet. Plus it was within walking distance and Sarah was coming with me. I had borrowed an amazing coat from the 70's and some equally amazing boots from Sarah, combined with a loud and obnoxious thrift store shirt and a miniskirt turned into something approximating a girl from the 70's. I made a valiant attempt at straightening my hair but it just wasn't going to happen. The party was fun, and not full of obnoxious drunk people. Although my favorite costume by far was the girl that came in a patient gown, covered in bandages, and with a foley catheter bag filled with tequila. I got home around midnight exhausted and immediately fell asleep.

Today has been lazy, I've just been cleaning up around the house, occasionally hacking up globs of green goo, and trying to get some rest. Probably should have done my homework, but it's Saturday and that somehow seems wrong. I'll probably still be trying to rest and recover tomorrow, so I can do homework then.

Oh, and before I go I should explain my decision from the last post. I've thought about going straight into graduate school and come to the conclusion that I'm not ready for that. This program is too fast to give us time to really apply all the things we are learning, we only get little tastes of applied nursing during clinical. I want to have the opportunity to be a bedside nurse for a while to figure out how it really works and have a better chance of focusing my graduate work on real life problems and potential solutions. Also, I've been a poor starving student for almost 6 years straight, I want a real job and some time to do the things I'm missing this year, like racing, dancing, and painting. And if I don't go to graduate school, that's okay too, since I'll likely make a better salary as a staff nurse than as nursing faculty. The main reasons that this decision makes my life easier are that I don't have to start working on grad school applications and I am much more likely to just come back to Portland in May. There's still a chance I'll stay in Rochester, but it's not real high.

One decision made

I'm going to work for at least a year before entering grad school. Suddenly life seems a lot less complicated.

Clinicals

I started my adult health rotation last week. I'll spend 5 weeks on a cardiovascular surgery floor, then 5 weeks on a short stay medical floor. Here's a quick rundown on what my weeks are going to look like from now until Christmas:

Mon: Lecture noon-8pm

Tues: Lecture 8am-3pm, go to clinical unit and copy patient information, write up a report on patient including primary diagnosis with pathophysiology, up to 6 comorbid diagnoses, explain their pathophysiology and effect on primary diagnosis, past medical history, drug cards for medications (up to 12), and a priority nursing diagnosis.

Wed: Clinical 7am-4pm, write up a report that includes assessment of patient, and nursing care plan with daignoses, interventions, expected outcomes, and method of evaluation.

Thurs: Clinical 7am-4pm, implement the care plan, write up an evaluation of whether it worked.

Fri: Simulation or Community Health (alternating Fridays). For simulation days, write SBAR report, critique partner's SBAR, blog, and comment on blog.

That's the summary for this class alone. I guess that's what happens when you take a single class worth 8 credits.

Other than the crazy workload, I think I'll really enjoy this clinical rotation. My instructor is great, gets really involved while we're on the floor. And the patient population is mostly interesting. I say mostly because I'm interested in cardiac surgery patients, but not vascular surgery patients. Vascular surgery is a lot of, "Oh, you had uncontrolled diabetes for your entire life, we're going to cut your gangrenous leg off now." I'm hoping to be assigned a cardiac patient for this week.

Also, our nurse manager had breakfast there for us on the first day. How cool is that?

I'll write more about clinicals when I start to get interesting stories to tell.

Grad school hunting

There are basically four schools and two degrees that I'm interested in. A master's degree (aka nurse practitioner license) and a PhD (aka license to do lots of research and teach). So I narrowed down my list of schools by finding ones that would a)be in places I'm willing to live b)have some way for me to work on both degrees at the same time and c)help me pay for those degrees. The list ended up being University of Rochester, Boston College, University of Pennsylvania, and OHSU. OHSU is sort of an honorable mention for reasons I'll explain later. Let's go through the pros and cons of each:

1. University of Rochester
Pros: I'm already here. MS/PhD dual degree program. Fully paid tuition for said program. Associated with a really high quality teaching hospital.
Cons: Staying in Rochester for 5 more years.

2. Boston College
Pros: 4 year MS/PhD program. Boston looks cool.
Cons: Boston's expensive. Not sure about the funding for this one. Reputation of not liking people from outside the area. Jesuit school, which may or may not matter.

3. University of Pennsylvania
Pros: Ivy league. Associated with nationally recognized hospital. Fully funded for PhD portion of program, plus $20K stipend. Philadelphia looks cool.
Cons: Have to fund the Master's degree myself (only one year). Moving to a new city.

4. OHSU
Pros: Portland! Faculty with my exact research interests. Associated with really good hospital. But mostly, Portland!
Cons: No dual degree program. No Adult Nurse Practitioner program (only Family). Bureaucracy.

So, based on this list Penn and UR are looking pretty good. But then I have to take into account what I actually want to do, which changes frequently. Right now I'm kinda liking the idea of bedside nursing, which I give up if I get my NP. But, I could still do if I just got my PhD. In which case, OHSU jumps to the top of the list. So, I think my plan right now is to apply for all of these things and then decide based on what I want to do when the decision has to be made. Usually there's an option to defer admission for a year, or start out part-time, which I could do while working a full-time job as an RN. Although I'm open to any suggestions for alternatives or additions to this plan.

Job hunting

This isn't so much hunting for jobs as deciding which ones I'm interested in. I love my chosen career already.

My first step was to shadow at Strong Memorial Hospital here in Rochester. They require you to shadow on the unit you're interested in before you can apply for the job. So I scheduled two shadows for last Monday, first on general oncology from 7am-11am and then on the bone marrow transplant floor from 11:30 to 3:30pm. I walked over in the dark early morning with Sarah, since she was shadowing on labor and delivery, and we got shuttled off to our respective units by the nursing recruiters.

I was introduced to my nurse, and she whisked me off to meet her first patient for the day. She was assigned 4 patients, 3 of whom had blood cancers. As I followed her around throughout the morning I just got more and more amazed at how efficient she was. She never stopped moving the entire 4 hours that I was shadowing with her. She saw and assessed patients, administered medications, hung a platelet transfusion, prepared a patient for discharge, prepares a patient for a surgery, reassured family members, fed a man who couldn't use his hands, and still somehow found the time to help out anyone that asked her for anything. The most amazing thing was how she managed to go from looking completely frazzled to looking completely composed the moment she stepped into a patient's room. I want to be like her someday. At 11 I realized that I hadn't been able to ask her any questions about the unit, but there was nothign that could be done about it, so I ran off to get lunch.

After lunch I was taken up to the bone marrow transplant unit. I was met by the charge nurse and the nurse manager (aka the people that hire people) and they were both very welcoming and eager to talk to me. First the charge nurse sent me into a team treatment planning meeting. It was very interesting, especially since they discussed the 3 patients I had met that morning on the oncology unit. When I got out of the meeting I had a long list of questions for the charge nurse, and she answered them all. Then I got a quick tour and description of the unit. They have 12 beds, all in private rooms. They take all kinds of patients, including pediatric patients, with every imagine disease that might need a bone marrow transplant. They do both autologous and allogeneic transplants, and they even have 4 outpatient infusion chairs. After my tour, I followed a couple of the nurses around for most of the day, just doing standard nursing stuff. Then I got to watch and help with an autologous transplant, and that was really cool. I actualy like the vibe and atmosphere better on the this floor than the oncology floor, but I still can't identify exactly why. I just felt more at home, probably because it's so similar to 5C at OHSU.

I got to talk to the nurse manager about the hiring and orientation process a little bit. They usually take 1-2 new graduates each year, and spend 12 weeks doing orientation (most units do 6-8 weeks). Orientation means working 1 on 1 with another nurse and learning how to do the day-to-day job. After orientation they let you loose to work on the unit as a regular nurse for a while. At some point during the next year, they send new hires to the ICU for a while to get critical care training. They also slowly introduce new hires to working with the pediatric patients during their first year. What this means is that nurses from this floor are the best trained in the hospital, but they also want you to commit to a year of full time work at the time of hire.

The next step for me at Strong would be to submit an application and get an interview set up. I will do that soon, but want to get to know my current clinical instructor better first so she can write me a recommendation. Based on the feedback I got from both the recruiter and the nurses on the unit I'm pretty confident that I would be offered a job on at least one, if not both of those units if I apply.

Job hunting in Portland has also progressed a little. I contacted OHSU a while ago to ask about working on the BMT floor as a new graduate. They said that yes, they do hire new grads, but I should just apply online when I'm about 6 weeks away from taking my NCLEX. I don't like that answer for a couple of reasons. First, I'd like to shadow on the floor. Second, I hate the OHSU online application process and have never had any luck with it. It sucks. I got my last job there through the Willamette Career Center after submitting dozens of applications online. Third, I don't know when I'll be able to take my NCLEX because I can't do it until UR gets some paperwork to whoever administers the exam. It might be delayed by a month or more after graduation. At Strong, I can work as a graduate nurse until I get my RN, it doesn't sound like that's a possibility at OHSU.

Based on all of the above, my mom contacted Dr. Meyers, who knows me fairly well and has always been very supportive of my nursing career plans. She kindly offered to get me in touch with the appropriate people to help get me a job on the BMT floor at OHSU. I haven't heard back from her yet, but I only emailed her on Thursday, so I need to give her some time. I lov having inside connections.

I haven't looked at jobs elseewhere yet. I'm betting that I'll either be in Rochester or Portland for graduate school though, so there isn't a whole lot of motivation to look elsewhere. I might check out the hiring process at some hospitals in Philadelphia (more on that in the grad school post) but that's probably it for now. It is pretty exciting knowing that wherever I go I will be able to get work, but I'd like to know that I can get the kind of work that I want.

Don't even know where to start...

A lot has happened in the past couple of weeks. So, I'll follow Matthew and Leah's lead and give a list of things to catch up on:

1. Job hunting
2. Graduate school hunting
3. Clinicals
4. Classes
5. Everything else

I'm going to try to write about most of that over this weekend, since once the week starts I have zero free time. I'm beginning to understand the true meaning of "accelerated program" and I'm loving it.

Recruitment

We're being seriously recruited. It's time to start thinking about where I'm going to apply for jobs and what kind of jobs those are going to be. Of course, my first choice of job would be to work on the BMT floor at OHSU. Since that is unlikely to mesh with my graduate school plans, I need to expand my search a little. Like, to the BMT floor at Strong Memorial Hospital in Rochester. Which, by the way, offers full tuition reimbursement for any classes at UofR for anyone that has a) worked at SMH for a year or b) worked in a university setting for a year. I believe I fall into category b. Pretty sweet deal, huh?

Then again, if I get into the MSN/PhD program, tuition is covered anyway. But, this would be a good backup in case I don't get accepted and end up doing just the MSN or something. Speaking of MSN/PhD programs, I've requested more information about the program at University of Pennsylvania (Ivy League, on my!) in Philadelphia. I hear good things about Philly from my housemates (they've both lived there) and Sarah and Ronen might consider following me there if I go, since they have an exceptional nurse midwifery program as well. Haven't discussed the whole moving thing much with Paul yet, I need to have a talk with him soon though.

I've been missing Portland a lot this week. Maybe because the weather has been so quintessentially Portland-like. About 65 degrees and misting rain. I love it, but it makes me homesick. Rochester is an okay place, but I would never choose to stay here because of the city itself, it would take something like getting into a fully-funded dual degree program to keep me here. I don't know if I would like Philadelphia any better, but I could at least visit there before moving. One definite perk of Philadelphia would be more access to the things I love to do, like cycling and dancing. There is no such thing as a women's cycling team in Rochester, the city is just too small to support it. And dancing is extremely limited and doesn't seem worth the effort to get out on a weeknight. Then again, if none of my friends came with me to Philadelphia, I'd have to start all over again.

Basically, I'm back to the waiting game, not sure if I'm hoping for my decision to be made for me by admissions committees or if I'd rather have all my options open and have to choose myself. So far my decision to come out here has proven to be a good one, but right now I"m really unsure if I want to stay for 5 more years.

A little more about the psychiatric hospital

People have asked me why I hate my psych rotation so much. It's not because I'm not interested in psychiatry, or because I don't get to be involved in patient care, although those would be reasons enough. It's because I come home angry and depressed every single day. So, here's a quick summary of the things that I have seen that make me so angry. I honestly hope it makes you angry too, because unless a whole lot of people get very upset about it, nothing is going to change.

First, there is one nurse for every 30 patients. That is simply not enough. The nurse spends his/her day filling out paperwork, not even giving medications (an LPN does that). Zero patient contact, unless a patient becomes disruptive or dangerous.

Second, the unit feels like a prison. There are locks on all the doors, and I understand that is out of necessity and cannot be changed. What could be changed are the institutional rooms, fluorescent lights, warnings posted on the walls, and complete lack of individualization of patient rooms. Several patients have said that they feel much happier and more stable when they're at the regular hospital or doing outpatient treatment, just because that place makes them depressed. Honestly, I would probably become suicidal after being locked in that unit for a month.

Third, there is nothing for the patients to do. The nurse is too busy to interact with them. The mental health techs don't seem to give a damn. The LPN just does medications. Who's left? Other patients. And they do okay together, but any time you put a group of 30 people together with no available form of distraction besides the one television there will be problems. Then do it with 30 mentally ill people, many of whom have impulse control problems or histories of violence, and you've just got a ticking bomb.

Fourth, the patients get medication, not treatment. Medication is not the same as treatment. The doctors don't seem to realize this, and the nurse and social workers are either too busy or too jaded to do anything about it. Medications help. They calm symptoms, like command hallucinations and extreme depression or mania, and make it possible for various types of therapy to be successful. There are several kinds of therapies available, and many of them are effective. But, they need to be implemented with consistency and expertise. One group therapy session each week is not going to make a difference in these patients' lives. So, instead of getting treatment, they get medicated to the point where they are "safe" (read: unable to feel or think straight) and then medicated some more to deal with the side effects of the original meds.

Fifth, the patients believe that nobody cares about them, with the possible exception of the social workers. And who can blame them, I've seen very little evidence to prove the patients wrong. Almost all of the staff are unapproachable and impatient. I don't blame them either, they are overworked, underpaid, and buried in paperwork.

So, who's to blame? Everybody. Why? Because none of us care enough to fix these problems. What's the fix, you ask? Easy, money. Mental health funding has been cut significantly in the past 10 years. They are now so broke at this place that they don't even have snacks or drinks other than water available between meal times. They have a full kitchen and used to bake cookies with patients. Now they can't afford the ingredients, so the appliances have been disconnected and the kitchen is locked. They used to get $200/month for the entire hospital (less than $1 per patient) for recreational therapy. That is going to disappear by the end of this year. They won't even be allowed to buy a deck of cards or a soccer ball, unless it comes out of the pocket of a staff member. This isn't a unique situation, this is standard for psychiatric hospitals around the country.

Where does the small amount of money that they do get end up? Paying staff to do paperwork. The amount of paperwork they have to do is beyond belief. Double, if not triple, anything I've seen at a regular hospital. That's why the nurses can't spend time with their patients, and the therapists don't have time to do more than one session per week. The intense overregulation of mental health care is preventing any actual care from being given.

So that's why I hate psych, because it's a broken system and there is nothing I can do about it, except be angry and try to care.

What's wrong with this picture?

There's a young man on my unit, let's call him Jim, who's a paranoid schizophrenic. He's in his early twenties and has a past history of violence, badly beating several patients, but nothing recently. Jim believes that people are trying to kill him, have already killed his father, and that he should be in the witness protection program. He is afraid of leaving the hospital because there will be an attempt on his life. He has constant and persistent hallucinations and delusions, despite the medication he is on. He's also one of the most thoughtful, soft-spoken, and caring gentlemen that I have ever met.

Today Jim came to the staff and told them that there was a wire in his leg and he had to go to the hospital. They explained to him that he is in the hospital already, he responded by turning around and punching the wall. Based on his history, staff called a "Camelot," meaning security came running and Jim was medicated and then isolated for the rest of the day. Had Jim punched a staff member instead, it says in his treatment plan that he would immediately be taken back to prison.

Compare Jim's story with another young man on my unit, let's call him Tom. Tom is also a schizophrenic and hears voices frequently, probably command hallucinations. He has attacked three people in the past four weeks, twice stating that he was trying to kill them. First he tried to choke another patient with headphone cables, then he tried to break someone's neck, finally he punched a lawyer in the face. Tom also has a history of imprisonment, and has been moved off of every regular unit at my hospital because he was a danger to the other patients. My unit was the last option, and so he's stuck there. After each incident, he was medicated and isolated, arrested briefly, and then returned to the unit because his actions did not qualify as severe enough to actually imprison him. Note that there is a forensic unit at this hospital specifically for criminals that have been found guilty by reason of insanity.

So, to sum up: Tom has a history of attempted murders. Jim gets frustrated and punches a wall. They both get the same treatment, except now if Tom punches somebody nothing different will happen. If Jim punches a person, he'll get taken to jail, setting back all the progress that has been made.

Anyone else have a problem with this?

Simulation Lab

Today was my first experience in the Sim Lab. I think I've mentioned it before... basically there's a room set up just like a hospital room with a dummy lying on the bed. The dummy has pulses, a bood pressure, breath and heart sounds, a peripheral IV, it can bleed, and the professor running the simulation can talk through it. SimLab is going to be really good, because in there we can do all the things that aren't allowed on real patients, like hang blood products, insert IV lines, etc.

This simulation was for Psych, so the situation we were given was of a woman going through alcohol withdrawal. It was based on the movie 28 Days about Sandra Bullock going through rehab. I have to admit, at first I thought it was the zombie movie, and was kind of wondering what sort of simulation we were going to be subjected to. We got to work in a group of three, which did help make things easier.

The simulation itself was nerve-wracking at first, but then just kind of fun. There is an assessment for patients suspected of going through alcohol withdrawal called the CIWA (Clinical Institute Withdrawal Assessment) and I was in charge of doing that, along with the CAGE questions to assess for alcohol addiction/dependence. (Have you ever wanted to Cut back on your alcohol intake? Do people seem Annoyed with you when you drink? Do you ever feel Guilty about drinking? Do you need an Eye-opener drink in the mornings?). She ended up scoring really high on the CIWA (hallucinations, dry heaves, sweating, loss of orientation) and got a nice valium drip going to calm her down. She was so happy about getting valium she even made up a little valium song for us (I think the instructor was having a little too much fun).

After the simulation was over we had to watch ourselves on video, which was by far the worst part. Then we were supposed to watch the rest of the movie, but we all just wanted to go home, including the instructor, so we left. In theory I could go check the DVD out from school and watch it any time. Not likely to happen.

I'm looking forward to future simulations, since they'll be done during our Adult Medical/Surgical course. They've already warned us that we'll be encountering a little bit of everything, so it should get very interesting.

Child psych unit

I had an "Alternate Site Visit" today. This is an attempt on the professors to show us more than one side of psychiatric nursing. So, I was assigned to go to the child psychiatric floor at the hospital. It was very, very hard, but not for the reasons that I expected. I expected to see kids that were completely out of control and/or medicated so heavily that they were partially sedated. Instead, I met a few kids that seemed pretty okay and a couple of autistic boys.

One of the autistic boys ran up and hugged me as soon as I walked in the room. He would then grab my hand and pull me around the floor every time he got excited about something because he wanted to share it with me.

The hard part started when I was helping a little girl clean her room after breakfast. She started talking about her family and showed me a picture of her dad. Then she told me a little about her mom and her grandparents. And finally she said, "My uncle isn't nice. He threw me down the stairs and gave me two black eyes. Then he beat up my mom." She said this in the same matter of fact voice that she had used to talk about her grandparents. I was at a complete loss for words. Later on, I got the chance to look at some of the kids charts. It turns out that this little girl had been brought into the hospital when she started trying to stab her grandmother with a steak knife. She was discharged this afternoon.

Another one of the kids had been brought in because of repeated attempts to run away from home. He even tried to jump out of a 12-story building in order to get away. Last winter he was found by a snowplow driver walking along the side of the road without a jacket or shoes on. Sounds crazy, huh? Until you keep reading and see that his father beat his mom and he witnessed it. He and his mother went to live with other relatives a couple of times, but his father always found them. His mom is currently living in a battered women's shelter, which this kid has also tried to run away from.

I was only on this floor for 4 hours, but I still got to spend enough time with the kids to see that they were all capable of being very smart and very sweet. They just didn't have the chance at home and all they had been exposed to was violence and abuse. I would have been running away or stabbing people too.

Quick update

I met with the director of the Ms/PhD program here last week. She talked me through the whole program, and how to pay for it, and how to apply. It was extremely helpful, and I've now decided that I will be applying. The program lasts 4-5 years and they only take 2-3 students each year, so I'm not sure if I'll get in but I can at least apply. I'm also looking at schools in Boston, Philadelphia, and San Fransisco. And I contacted OHSU to see if I could do their Master's and PhD programs simultaneously. Unfortunately, it sounds like I'll need to get an Adult Nurse Practitioner license, which OHSU does not offer.

In other news, I've been having a great time with my housemates. Jess continues to bake cookies every night (coincidentally, I started going to the gym again) and Jordan is rarely around but when he is we generally geek out together about health stuff or gadgets like my new iPod. I've settled in well and I really love living here.

Things are still going well with Paul and I. His parents will be in town for a little while at the end of the week, so I'll probably be meeting them. Since my schedule is completely wacky and his is completely normal we have difficulty getting a lot of time together, but that'll be changing as soon as I'm done with Psych.

Speaking of psych, I hate it. I don't really feel the need to elaborate, except to say that mental health care is an oxymoron and I'm spending my clinical time angry and frustrated. I will be very glad when it's over.

We had the tail end of Hurricane Ike come through Rochester last night. Wind was gusting up to 60mph and blew down many trees and knocked our power out for about 18 hours (midnight until I got home this evening). Luckily I was in class almost all day, so it didn't really affect me too much, still very annoying and by far the longest power outage I can remember. The only casualty was our ice cream.

Sarah and I have a plan to go to the gym together three times every week starting on Monday. We'll see if it works, but I think it'll help me a lot to be responsible to someone. Ideally I'd like to be 15-20 pounds lighter by the beginning of the collegiate cycling season next spring. That should be doable, as long as I work hard at it and Jess's cookie production slows down.

School stuff

Classes started on Tuesday. I'm currently taking Psych/Mental Health, Research, and Therapeutic Interventions 2 (aka "The Tubes and Tests Course"). On Tuesday I picked up my shiny new toy, which came with a drug guide and lab tests guide. Not that I've used those yet, but they're available. I also had my first lab, where we "learned" how to take stool and urine samples (The trick is to catch the pee in the cup!), and my first psych lecture. We didn't really learn anything in psych except about the dress code.

Acceptable professional attire includes tasteful (business style) skirts, slacks, jumpers, dress blouses, tailored shirts, turtlenecks, sweaters, jackets or blazers. Please do not wear denim, jean-like, or khaki material. Lab coats should not be worn. Footwear may be any conventional color except white. No white socks, sneakers, athletic shoes, open-toed shoes, sandals or high heels. When boots are needed for inclement weather, students will need to change to appropriate shoes for their clinical work. Book bags and coats should be placed in lockers because they are not permitted in clinical sites. Minimal jewelry is recommended (for example, a wedding band, watch with second hand, plain stud earrings). Please do not wear large earrings or hoops. If you wear make-up, please wear it tastefully. Please do not wear perfume or after shave lotion. No nail polish and length of natural nails is no longer than 1/4 inch from the finger tip.

Now, that doesn't sound so bad, except I don't wear any of that stuff. I wear tank tops, t-shirts, capris, and cargo pants. Other than that, everything I own is really formal. So, I had to go shopping yesterday. I spent way too much money, but managed to get a couple of nice tops, some dress pants, and a pair of appropriate shoes. I also got myself a pair of jeans, ordered a bridesmaid dress for Matthew and Leah's wedding, did some grocery shopping and forgot to take my passport application to the post office. Still, not bad for one afternoon with a zipcar.

Today was my orientation to Rochester Psychiatric Center, which will be my clinical site for the next 5 weeks. It's going to be interesting, but I don't think I'm going to enjoy it. Because these patients can pretty much take care of all their basic needs independently, and we're not going to be allowed to pass meds there, we'll mostly be observing. But who knows, I might surprise myself. We did get to have a very interesting discussion with three recovering/recovered patients that are now "patient advocates". They come in and talk to current patients and help them get their lives figured out. Hearing about their experiences dealing with their mental illnesses was quite amazing, especially when compared with how stable they all are now. Two of them had been homeless, one had stolen a car without realizing it, all three had spent time in prison for various charges, but now they all have jobs, apartments, and are rebuilding their relationships with friends and family. It was really fascinating, and a good way to help us remember that the patients we meet will most likely recover, even if it takes years.

Housemate bonding time

Today was so much fun. Turns out Jess and I get along very well, and we both like to bake. This could be a dangerous combination. We started today by going to the Public Market, where we both bought enough food that we could barely carry any more. Me at the market without the bike limiting what I buy spells trouble. So, once we got home, we scrounged up some lunch and proceeded to bake stuff. Jess made snickerdoodles and I made zucchini muffins and everybody got to happily eat all afternoon. Then we both took naps, woke up, and started to make dinner. We decided on black bean burgers (Jordan is vegetarian, and Jess and I are both happy to eat veggie), which had me a little intimidated at first, but were amazingly easy. We didn't even follow a recipe, just sorta made it up. A combination of black beans, crumbled toast, red bell pepper, onion, parsley, chili powder, an egg, some salsa, and I think that's it. All mashed together and formed into burger-shaped things, then grilled. They tasted like a burrito turned into a burger. We also made corn (6 ears for a dollar!) and drank some really good Oregon wine. It was a delicious dinner, and I nice way to get to know my new housemates.

I wish I could spend more time with Jordan before school starts for me, but school has already started for him so he spends most of his time studying for an upcoming neuro exam. Memorizing the parts of the brain and the names of the blood vessels and stuff. And he proves to me every day that I made the right choice by not going to medical school.

Speaking of medical stuff, I got attacked by either a nasty bug of some kind or the most potent poisonous plant I've ever encountered sometime during my visit. What started as some ugly bumps on my legs first turned into angry red splotches covered in blisters and have now become scabby, weepy, nasty and even bigger than before. I'm hoping that the scabbiness means they're healing finally. I took pictures of them, but they're pretty gross so I won't post them unless requested. And, I'm starting to find new angry red bumps on my legs and now on my forearm. I'm worried that by scratching I've spread whatever the original cause of the reaction was around. But, that doesn't make sense, since these things have been there for a week and a half and there's no way I've still got residual poisonous substances on me. I just don't know, but at least I've got access to a whole lot of nurses and nurse practitioners if it doesn't start to heal up.

Oh, last night Paul and I went to see Iron Man. I know, I'm slow about these things. But, it was really good. Tomorrow we're going to go spend the afternoon/evening at his friend Eric's cottage on a lake somewhere (not Lake Ontario). It will be fun. I've started meeting more people in the Paul/Sarah/Ronen friend group, and I like them all. And they play lots of board games, which I like even more. I was a little intimidated at first by the people at a board game night on Thursday, but managed to relax after the first game or so and actually started joining in the conversation.

I think that's it for now. I'm going to go curl up with my new Neil Gaiman book stolen from Jess (I love Neil Gaiman! Why didn't I start reading this stuff earlier?) and chill out a little before bed. Two more days of vacation...

Vacation, moving, and getting ready for school

Vacation was great. I did a lot of stuff, saw a lot of people, and had a lot of fun. Highlights include: Lauren's graduation picnic, riding the Portland Century, special dance at Tuesday Blues, and several episodes of hysterical giggling over nothing in particular. I"m not going to recap the whole vacation because most of the people that read this blog were there.

I am now moved into my new home in Rochester. It's an adorable house recently bought by Jordan and Jess. He's a second year med student and she's an elementary music teacher. They're both really sweet and we get along great. Jess and I spent the afternoon shopping and admiring our respective book collections. I've already taken a few of hers and given her a few of mine. I've also spent a lot of time playing with Heidi, Jess's cat. Heidi is also very sweet and quite friendly. She's not up to sitting on my lap yet, but she's often found exploring my room or sitting in my windows. My room is huge, about twice the size of the previous one, and they funished it for me with a bed, dresser, and desk. I've got some more organizing to do, but I'm making a lot of progress on it. There's an enormous wooden headboard leaning on one wall that I can do anything I want with. So far I've considered covering it with hooks and using it to hang stuff, or maybe sticking a shelf on it, but I'm open to suggestions.

Yesterday, after the one hour it took to move my stuff, Paul and I went hiking at Mendon Ponds. I didn't realize until visiting that website that they have a raptor rescue facility there. I'll have to check it out some day. Too bad I'm too busy to be a volunteer, I could actually put my hawk glove to use again. The park is beautiful, I can't wait to see it when the leaves have changed color. After we got back, and I took a nap, we wandered over to Sarah's to visit with them and the kids. They left today for a friend's farm so this was my only chance to see her before classes start. The kids are adorable and crazy, as usual, and Sarah was stressed out as usual, but we had a good time anyway. Then I came back to my new place (less than a 5 minute walk!) and started the unpacking process. It's a long process, and still very much in progress. I'll post pictures once things are a little more sorted out here.

Tonight I think I'm going to play board games with Paul and some friends that I may or may not have met yet. Tomorrow will be more unpacking and organizing and probably involve going over to the hospital to buy my books. In the meantime I'm going to make some dinner and try to get through some of my growing stack of reading material. It's so fun having friends with good book collections!

Life, clinicals, and almost done...

Two more days before I'm finished with one third of my nursing program. I'm almost one third of a nurse. That's a little scary.

Life outside of school has been going extremely well lately. First and foremost, the bat guys came today and did their work on the house. So, there should be no more bat invasions, and no unpleasant surprises for my incoming sublettor (sublessor? sublessee? I have no idea...)

Secondly, I had dinner with my soon-to-be housemates last night. They are wonderful! And they love to cook, and are very good at it. Jordan is a second year medical student and Jessica is a music teacher who is going back to school for a Master's in counseling. They invited me over for a "simple dinner" which included panini (on their shiny new panini maker!) salad, pasta, chips and hummus, wine, and peach cobbler. And it was all fabulous. I'm going to like living with these people. One of their friends was there too, a blind pianist from Eastman School of Music who had just returned from an international piano competition in Moscow. A really amazing guy, with a lot of good stories. The four of us got along great right from the start, lots of laughing and making plans for the house, and going on outings together, and all sorts of hilarity. I had a blast, and stayed way past my bed time on a clinical night, but it was completely worthwhile. I'll be moving into the house as soon as I can after I return from Portland.

The whole Paul thing is going rather well right now too. There was a day of canoing on the Genessee River, and some cuddling, and the purchase of a webcam for me so that we can chat to each other while gallivanting around the west coast. He's currently in San Diego at a conference, and won't get back until Friday, the day before I leave for Portland. Bad timing, but the webcam/Skype thing is pretty cool. Sarah seems to be incredibly proud of herself for managing to set us up.

Lastly, school stuff. Like I said, I'm almost done with this semester. I've determined through this clinical rotation that I have no interest in working on an ENT floor. I prefer patients that can talk to me, and so far I haven't had a single one of those on this floor. A lot of them have trachs and that makes talking very difficult unless they use a speaking valve, which can make breathing difficult. Usually they choose breathing. Also, I don't enjoy phlegm and sputum. I'd honestly rather deal with vomit and diarrhea. The whole suctioning out a trach thing is quite gross to see, but even worse to listen to. My next rotation will be Psych, on the Mentally Ill/Clinically Addicted floor. That will be very different and probably really cool. I bet I'll be longing for the patients that don't talk after five weeks of patients in withdrawal, though. And then I'm on the Cardiac Surgery floor, which I'm looking forward to a lot. Oh, and there will be a ton of classes mixed in with that stuff too. Fall is supposed to be the hardest semester of this course. Can't wait.

I think that's about it for now. I don't know how much I'll be posting from Portland, but I'll definitely be getting photos of my new place up here as soon as I can after moving in. So exciting!

Weekend update

After clinicals on Friday I was pretty well exhausted, but we had our usual Friday night dinner at Sarah's planned. So I took a nap, relaxed for a little while, and then rode over there to hang out with Sarah, Ronen, Paul, and the babies. The babies were particularly fussy that night, but it didn't stop us from having a fun evening that included a good game of Settlers.

At some point during the evening Sarah and Ronen asked me if I could babysit for them that Saturday night. Of course I said yes, they've been such wonderful friends that it's the very least I could do for them. Besides, they weren't going to need me until after the babies were put to bed. At some point after that plan had been made, someone suggested that Paul should come over and keep me company while I was babysitting. He said maybe. At some other point in the evening, I asked Paul if there was a good way to bike down to David's Bridal so I could try on dresses for Matthew and Leah's wedding. The only direct route is along a road that is decidedly unsafe for bikes. He not only told me there was a route, but offered to show me personally some time this weekend. I, of course, said that I would really like that (even though the route seemed straightforward enough) and so we planned that I would give him a call when I knew what time would work best.

Fast forward to Saturday. I had a bat proofing company come at 8am to inspect the house, give an estimate, and make arrangements for them to come back and do the actual work. After that I went straight back to bed and didn't get up until noon. Then I went about my usual Saturday grocery shopping and did some minor stuff around the house and homework. Around 5:30 I called Paul and told him that Sunday around noon would be a good time to go for that bike ride. He informed me that his possible plans for that evening had been cancelled and so he'd be coming over to babysit too, which was a pleasant surprise. I then called Sarah and asked her for a ride to her place, since I knew I'd be too exhausted to ride my bike back home at midnight. She then informed me that Paul would be coming to babysit too, at which I laughed and decided that we should just do conference calls. Around 7:00 Sarah and Yasmine picked me up (apparently Yasmine was really excited that they were going to get m and insisted on coming) and I got to play with the babies for a little while before bedtime. Paul showed up during the whole bedtime process (it usually takes about 30-45 minutes, and involves no loud noises downstairs and frequent screaming from upstairs) and eventually Sarah and Ronen got to go out for their date.

Paul and I just talked for a nice long time, but just before 10pm, Maya started crying. Maya doesn't go back to sleep on her own, so I had to go up there and do my best to calm down a very upset one year old. She finally fell asleep on my shoulder after about 15 minutes, and I got her down in the crib, but as soon as I tried to open the door and leave her room she woke up screaming again. Around the half hour mark I gave in and called Sarah. She told me to just take Maya downstairs to play for a while, and she and Ronen would be home as soon as the movie was over. She didn't realize that the movie was over 2.5 hours (they saw Dark Knight). But, Paul and I managed to keep the little baby content for as long as it took, and she was awfully cute, even though she should have been asleep. When Sarah and Ronen got home they were very grateful and Paul and I were both exhausted. He gave me a ride home, and somewhere along the way asked me if I would like to go to a soccer game tomorrow evening. I said yes, gave him a very tired hug, and immediately collapsed in bed.

Today, I had to go get my rabies shot at 10am, which took almost no time at all. And then around noon, when I'd had some real breakfast and done a little bit of homework, I called up Paul and we went off on our dress trying on excursion. The ride was fun, and quite pretty along the Erie canal. Paul valiantly stuck around while I did the dress thing, and then we rode back. He left me at home so I could get a little more homework done, and a shower, before picking me up for the soccer game. The Rochester Rhinos are not a very good team, but they're a lot of fun to watch. I don't think I've been to any pro soccer games before and I really liked it. I might even have to go again some time. We cheered, and booed, and yelled at the refs, and laughed at the cheerleaders, and generally had a lot of fun. And Paul was a total gentleman and opened my car door for me, held my hand, paid for my ticket, offered me his jacket, etc. I think this might qualify as a first date.

So, this was a very good, but not terribly productive weekend. For the next week I have to write up a nursing care plan for my assigned patient from last week's clinicals, go through a mid-term evaluation with my clinical instructor, verify the transcipt that Nami and Nina put together last week, transcribe my part of this week's focus group session, and work my W,Th,F clinical shifts. It's going to be another long and exhausting week. Only two left.

Clinicals

I should be making up medication cards instead of writing this, but that's the way that procrastination goes when I don't have the energy to bake something.

I've now done a whopping 5 clinical days in two locations. My clinical group consists of 8 students and 1 instructor. The way it works is we invade a unit of some kind, get an assigned patient (only one) to take care of for the day/week/whatever, and then are let loose on the floor. Kinda scary, huh? We work W,Th,F from 7-3 every week with a post-conference from 3-4. We do some shadowing of the RN's, and we follow instructions when given, but mostly we're left to manage whatever parts of our patients' care we can (either limited by legality or our learned skills) completely independently. That includes bathing, oral care, feeding, dressing, changing, repositioning, dressing changes, range of motion exercises, and whatever special sorts of things they may need. Like emptying ileostomy bags. As we learn more skills in class and lab, we get to practice them on our patients. For example, I'll be giving heparin and insulin injections for the first time tomorrow.

So, my first unit was in a long term care facility. Also called a nursing home, but that's less PC nowadays. My patient was the only one that was lucid enough to hold a conversation, but needed plenty of care because a stroke had paralyzed half her body. So I did whatever I needed to do for her, and let her husband do whatever he could, and then spent the rest of the day just sitting around. The pace in that kind of facility is not particularly fast, so there was never really a lot to do. I spent most of my time bathing and changing people. I also got my first real exposure to tracheostomy tubes. They tend to fill with phlegm almost constantly, not something that is usually seen on TV. The other thing that I got to use a lot was the Hoyer lift (A less swanky version of this. The soundtrack to that video just makes me laugh). Hoyer's are fabulous for patients that can't get up on their own for whatever reason and are too heavy to be lifted easily or safely.

My second clinical unit is a lot more exciting. We're on the ENT (ear, nose, throat) floor, which also happens to serve as a regular medical floor too. There are a lot more staff, the patients are a lot sicker, and everything moves quite quickly. I was running around most of the day today without any real downtime until about 2pm. I was mostly taking care of my patient, but did a lot of assisting with other stuff too. My patient is nonverbal and mostly immobile, but alert and aware of his surroundings. He had a trach for a while, but it was removed. He's the one with the ileostomy, and he also has a feeding tube and gets nothing by mouth. His medical diagnoses are numerous and complicated, but the prognosis is not great. He'll probably survive a long time, but is unlikely to regain mobility or speech. The only reason he's still in the hospital is that they haven't been able to find him a placement in a nursing home yet. It's a very sad situation.

I've only got two more weeks before the end of my first semester of nursing school. Wow, this is going by fast.

Clearly Monday was too optimistic

This one is going to be another quick and dirty list.

1. The wedding was beautiful and I had a lot of fun with all my Oregon (and other) friends.
2. I made it back to Rochester without a problem and even got a 3 hour nap on the floor of the Philadelphia airport.
3. Sarah kidnapped me for hanging out on Monday and I fell asleep on her couch after dinner. Ronen was kind enough to drive me home.
4. I've started my Acute Care clinical. It's a lot more exciting than Long Term Care was. I'll elaborate more about clinicals when I'm less busy (read: after August 15th).
5. I emailed my landlord and there will be bat-proofers coming to check out the house either Saturday or Monday. Apparently after the initial bullying attempt he becomes a reasonable person.
6. I have an RIT student coming tomorrow night to check out my room and the house to see if he would like to sublet. Therefore the rest of the night will be spent cleaning and then collapsing in bed.

And finally, a plea for help. My suitcases were stored in the basement and apparently that was a poor choice, because they are now filled with bugs and spiders and various creatures that I don't want in my stuff (not sure about bats). Any ideas on how to rid said suitcases of said critters?

Quick update

1. I'm ignoring my landlord until after the weekend
2. Clinicals are going well, but were mostly anticlimactic
3. I have wonderful friends, both in Portland and Rochester
4. Storing luggage in a dirty basement is a bad idea
5. I arrive in Portland at 10:30pm tomorrow and leave again at 10:30pm Sunday
6. There will probably not be another update until Monday

Righteous Anger

See the title? That's what's powering this post, since I certainly don't have any energy left. Here's the crux of the reply from my landlord:

You had no right to act on your own behalf without my consent. You had no right to go into my bedroom which is trespassing. And you had no right to make alterations to the house. There will be no refund granted. Had you contacted me first I would have had my bat person come out.

Seriously, he would rather I had called him at 3am? And trespassing? Next time I lock the bats in his bedroom and leave them there.

I'll post about clinicals and other stuff when I have energy again. Don't hold your breath.

Feeling better

I'm back home now, having spent a really nice day hanging out with Sarah and the little ones. I had gone over to her house to do that online exam, because if I went home I was pretty sure I would forget about it, and ended up staying until after dinner. She gave me lots of hugs, fed me, chatted with me, let me play with her adorable children, and generally did a fabulous job of cheering me up. I think Maya is starting to get to know me, and Yasmine will usually give me random flying hug attacks throughout the day and won't let me leave without saying goodbye. It's very sweet and cute and a perfect way to forget about stressful life stuff. We even went for a walk to the park after Ronen got home and I got to play with more adorable small children, including a set of 2 year old twins named Henry and Calvin who insisted on repeatedly filling my hands with woodchips.

Tomorrow is my first day of clinicals. I'm going to a long term care facility close-ish to the hospital, but far enough that I'll be carpooling with my friend Laura. I offered to buy the coffee if she'd drive, which I think is a good deal. We have to be there at 7:00am, so I'm meeting her at her house by 6:30, just to be sure that we're not late on our first day. I have a few final things to do before I'm ready to go, but otherwise I should be all set. I'm sure I will have a lot to talk about after this first day, but I may not get to blogging about it until later, depending on how long I need to recover.

Even more bats. No, I'm not joking.

Last night there were two bats in my room. This time, being about 3am, I woke up when I heard the fluttering sounds. I thought I had been dreaming about bats until I saw a dark shape fly across my ceiling. I turned on my light, and there was indeed a bat in my room. Again. So, I opened the screens in my windows, grabbed my pillow and blanket and made for the doorway. I paused in the doorway for a minute hoping that it would just fly out the window, but no luck. Just as I was trying to time my exit so that the bat wouldn't follow me out, a second bat appeared. It must have flown in through the window, but it seemed to come out of nowhere. Now I was really freaked out. For one, the chances of a bat following me downstairs had doubled. Secondly, if there were two bats, there were probably more. So, using my pillow to protect my head, I dashed back to my nightstand to grab my phone and then quickly ran out the door. I'm pretty sure I smacked one of the bats with the pillow on my way out, but oddly feel no remorse whatsoever. I also stuffed a towel under the doorway.

When I got out into the hallway the first thing I noticed was that there were no bats with me. Good. The second thing I noticed was that there was a light coming from under Robert's door. I knocked, loudly. He answered, I told him there were bats in my room, and we looked up animal control on his laptop. When I called them they said that bats are treated just like mice and rats, meaning that I had to call a pest control company and the county wasn't going to do anything about it. After some deliberation, I checked the phone book for a 24hr pest control. I found one, and the guy said he could be there in an hour and a half. Ugh.

At this point, Robert wanted to get to bed, but was kind enough to loan me his laptop so I could sit downstairs, with all the lights on, trying not to panic, and watch episodes of Family Guy until the official bat remover showed up. He showed up exactly on time, for which I was grateful, and when we opened the door to my room the bats were gone. No surprise, since the screens had been open the entire time. He did do a thorough check of the entire room making sure that there was no way bats could get in and that there were no remaining bats lurking anywhere.

At this point it was already becoming daylight so we went outside to see if he could spot how the bats were getting in. Turns out there's no cap on our chimney and there are cracks and holes all along the eaves of the house. Delightful. So, with this new knowledge, we went into the attic, which is also Jon's bedroom. Up there he found bat droppings around the chimney, a window that had a 1 inch opening, and lots of holes and cracks that bats could squeeze through. Luckily the only thing he didn't find was more bats.

He offered to do some temporary sealing up of the attic in order to keep bats out until I can contact Jon regarding bat-proofing the house. I jumped at the offer, and he filled in all the little holes and cracks with a foam stuff. He also duct-taped around the doors to the attic and duct-taped a plastic bag over the heating vent in my room, just in case. So now, if a bat does manage to get in, it should at least be contained in the attic. If Jon comes home to find that bats have trashed his room, I really couldn't care less.

So, the grand total for about one hour of work, done from 5-6am, was $160. He estimates the cost of a full bat-proofing at about $3000. There's no way Jon is going to pay that. Especially since he already paid $500 to a different company to supposedly bat-proof the house back in January (He left the receipt on the bookcase downstairs). The guy that I had called in said that Jon got completely ripped off. But there's a one year guarantee on that receipt, so maybe they'll come back and actually fix things. I'm mostly concerned about what will happen if the bat problem continues when I sublet this room. So I'm planning to call Jon this afternoon and at least get reimbursed for the cost of the one pest control visit and see what else he can do about the whole problem.

So, I had about another night of about 2-3 hours of sleep, managed to drag myself back out of bed to get to lab at 8am, and then found a flat tire on my bike. This was not a good morning. I changed the tire, and showed up for lab about 30 minutes late and started crying as soon as someone asked me if I was okay. I managed to get under control for the duration of lab, until a few friends came over to hug me and I lost it again. One of those friends insisted on buying me coffee and a muffin, which helped a lot. And now I have to go take an online exam. I'll update more as the situation progresses.

More battiness

This whole bat thing just keeps on going. I did some research online today and according to the CDC anyone that wakes up with a bat in their room (it doesn't even specify whether the bat lands on your head) should get vaccinated for rabies. This was not what I wanted to see, but I decided to go along with it since rabies is rather fatal.

So I called the university health services weekend number and the nice doctor on call told me that I should go immediately to the emergency room because they are the only ones sure to have the vaccine and be open on a Sunday. So I went, after I had finished watching today's stage of the Tour, and began my 4 hour journey through the Strong Memorial Emergency Department. Each time I told someone I was there for a rabies shot because a bat landed on my head the look they gave me was slightly more incredulous.

After being shuttled from waiting room to waiting room, listening to an elderly German couple reminisce about Heidelberg, and getting my scalp inspected for bite marks by a nice physician's assistant, I finally got into a real exam room. A pair of nurses came in looking incredibly apologetic and carrying a handful of syringes. They explained that I was going to be given a rabies vaccine, the first in a series spread over the next 15 days, and some immunoglobulin. Unfortunately, the immunoglobulin had to be split into 5 separate shots because you can only give a certain amount in each intramuscular injection. And because I was going to get so many shots, they wanted to put them into the largest muscle possible. That meant that I got a grand total of six shots in the butt today. They stood on either side of me doing simultaneous injections, so now I have two bruised areas with hard lumps of fluid under them. The lumps have been slowly going down over the course of the day, but it still feels pretty bruised.

Tomorrow I can expect a call from the Monroe County Health Department (they reported the whole bat incident to the health department) to schedule a time and place for my remaining injections. Luckily those ones will just be for rabies, no more immunoglobulin. I don't know how that will work with me going to the wedding next weekend, but I guess that will be figured out tomorrow.

I spent the rest of the day feeling sorry for myself and waiting out the rain so I could go grocery shopping. I managed to get to the store in dry weather, but on the way home was caught in a truly torrential downpour. My groceries survived mostly unscathed, but there was not a single dry spot on me. All my clothes are now hanging in the bathroom and I hope my backpack dries out before tomorrow.

Chiroptophobia

I didn't think I was afraid of bats before I went to bed last night. Then, around 2am, something with claws landed directly on my head and woke me up. I bolted straight upright in bed, which was a mistake, because there was now a very freaked out bat flying in eccentric circles around my room. I quickly lay back down so it wouldn't hit me in the face and, after the initial shock wore off, made a duck and cover run for the door, all the while thinking, "Bats are the main vector of rabies. I'm going to get bitten and go insane." Clearly I am not at my most lucid at 2am after being violently awoken.

Of course, when I made this run for the door, I didn't give any thought to the fact that there was no way for the bat to get out of the house. I paced in the hallway for what seemed like a very long time, and eventually the bat landed somewhere in the vicinity of my closet. There was no chance that I could get back to sleep knowing that there was a bat in the room, even if it stayed put all night, so I decided to make a dash back into the room, grab my phone, and do what any scared girl would do in my situation. Call my dad. Luckily, it was only 11:30ish Portland time.

He very kindly didn't laugh at me too much and suggested I open the screen of my windows, grab a blanket, close my bedroom door, and go sleep downstairs and the bat would make its own way out of my room. Well, I fell asleep on the couch, and about an hour later was woken up again by fluttering noises. Turns out the bat had made its way out of my room, by somehow crawling under the door, and was now flying around downstairs. It ended up doing loops around the kitchen, and I now had absolutely no clue what to do with it, since there is nowhere downstairs to trap it and the doors all have springy screen doors that I can't leave open. So what did I do? Called my dad again. By now it was 1:30ish Portland time, but I was too freaked out to care.

While talking to him trying to figure out what to do, the bat left the kitchen, and flew upstairs. After a few minutes I heard a lot of bursts of extra loud fluttering, and then silence. And then another burst, and more silence. So I slowly crept up the stairs, fully expecting the bat to come flying at my face in the narrow stairwell. It didn't, and when I reached the top of the stairs, I discovered that the bat had got itself caught in the shower and kept flying into the shower curtain. So the first thing I did was close the bathroom door. Now I had a bat trapped in the bathroom, with no means of escape. That wasn't something that I wanted to deal with when I woke up in the morning, or leave for one of my roommates to discover (they were all gone for the night). So, with paternal encouragement, I opened the bathroom door, darted inside, closed the door behind me, pulled the window screen open, and then ran out of the bathroom, closing the door behind me. Fortunately the bat stayed in the shower. I made sure there were no cracks around the door that the bat could squeeze through, and then, after much reassurance, finally got back into bed.

I think it was 5am at this point. I tossed and turned for a long time, listening to imagined fluttering sounds. My alarm went off at 7:30 because I had to be in lab this morning (I don't like Saturday classes). So my calculations give me about 2-3 hours of real sleep. Not enough. When I woke up I really had to pee, but I spent several minutes listening at the bathroom door for signs of the bat. I didn't hear anything, so I went in. I still didn't see or hear it, so I poked at the shower curtain, hoping to scare it into movement if it was still there. Nothing. So I peeked into the shower and it looked like the bat was gone. There was much exhausted rejoicing.

I was like a zombie in lab, barely responding to anything, and when I got home I just collapsed in bed for an hour but the heat eventually woke me up. Now I'm trying to stay cool, but failing miserably. I think I might go for a bike ride. If I'm going to be overheating and sweating anyway, I might as well be getting exercise.

Wound care, catheters, and trach tubes

I get to watch fun videos for this course. Tonight was oxygen therapy, wound care, urinary/bowel function, and urinary catheters. It's remarkable to me how bad the acting is in these videos, especially when the nurse says something like, "I'm not making you uncomfortable, am I?" while inserting a catheter. Umm... I don't think there's any way to make that experience NOT uncomfortable. You can make it LESS uncomfortable, but no one is ever going to say, "That was fun, let's do it again!"

This week I've got lab on Saturday, which is where I'll practice all of the fun stuff that I watched in the videos. We only get to do it on mannequins, though, not each other. It wouldn't be fair for the 1-2 guys in each lab group to have to suffer through every other student inserting and removing a catheter on them, after all. Funny, but not nice. Though I don't know how nice it'll be for the first real patient that I get to do it on...

Class is just plugging along slowly, trying to get us up to speed on all the basics we'll need for clinicals next week. After class today I went home with Sarah to hang out. We went out for lunch, chatted about everything, but mostly boys. We've concluded that boys are dumb (sorry, boys) but we like them anyway. Then we tried to do some homework, succeeded briefly, and continued to chat until she had to go to lab. I'll probably be going back over there tomorrow night for the weekly "get Paul and Caitlin in the same place" dinner.

This weekend I'll be spending most of my time transcribing the group session that happens tomorrow morning. I hope I'll get the audio file early enough that I can get a lot of it done tomorrow afternoon. I also hope that it doesn't take as long as I think it will, but that's not likely. Today was my last day of real relaxing fun time before the normal school craziness comes back in full force. I'm actually looking forward to it though, since I've had a little too much free time on my hands lately. I don't think I'll ever get over my need to be busy all the time.

EDIT: There are now 5 sprouts. All of them look a little different. It's very exciting.

Sprout!

Part of the care package I got last month was a collection of seeds. Some were just in the usual packets, but there was also a sheet of handmade paper with seeds embedded inside. The instructions on the paper said to just plant it directly into some soil and the seed will grow, so that's what I did. These are my little improvised pots, each with a section of the paper planted in it. From left to right they originally contained peanut butter, salsa, and gatorade. I'll keep the seedlings in there until they get too big and then improvise something else... maybe a milk jug or cottage cheese container :)

I planted the papers on Friday morning, and today found my first little green sprout! I have no idea what it is, since the seeds were just a collection of wildflowers. With luck, it'll survive long enough for me to figure out what it is. I'll keep you updated on its progress.

Rainy Day

I'm loving the rain right now. Yesterday was a miserable 90 degrees with the sticky humidity permeating everything. Today it is about 70 and raining, which just feels like Portland.

I'm done with my first classes. I've written the last paper and taken all the tests. I have most of the grades back, but not quite all. Some are better than others, but I should pull at least an A- in everything, I think. I'm actually going to go talk to my pharmacology professor about my clinical paper assignment, because I either really screwed up something and can't figure out what, or the TA that graded my paper didn't do a very good job. I'll find out which tomorrow.

This weekend has been pretty lazy. I spent all day Thursday at Muddy Waters writing my genetics paper. Friday I lay around the house watching a really good stage of the Tour, then went for a ride in the rain that was sadly cut short by a flat tire. I changed the tire but the pump I carry with me is only powerful enough to inflate the tire to 75%. That's enough to get home on, but isn't fun to do any real riding on and any underinflated tire is more likely to flat again. After I got home I was covered in mud and grease and spent about an hour scrubbing myself clean.

I then ate lunch and promptly fell asleep while attempting to read. Luckily I woke up in time to get dressed and head over to Sarah's for a game night. Unluckily, I decided to pump up Johnny's tires before I left and managed to break the valve and let all the air out. That meant that I would have to change the tire, which takes a ridiculously long time on Johnny because his tires are kevlar and not very stretchy. So I called Sarah and she came to pick me up. She had Yasmine and Maya with her and Maya was not very happy at all. She's got a probable yeast infection, and was doing a lot of screaming. Anyway, when we got home Sarah took care of Maya while I got a lesson in cucumber peeling from Ronen. Apparently there's a very particular way to do these things in his family. Paul showed up at some point and we were all put to work getting dinner ready. Dinner involved the usual toddler-induced hilarity and chaos. After dinner, while the little ones were being put to bed, Paul and I made cookies and got Settlers out to play. We played the Cities and Knights version, which I had only played a couple of times before but really like. Paul beat us without too much competition, and then we just sat around chatting until Sarah looked like she was going to fall out of her chair from exhaustion. I got a ride home from Paul and immediately passed out in bed.

Yesterday was supposed to be my first day of working on the Fuld project. I met up with Elspeth, another friend from class who is working on the project with me, and we rode our bikes to an STD clinic in the "bad part of town." It's actually about a mile away from my house, but it's amazing how the neighborhood changes in a very short distance. It's not a dangerous place to be in the middle of the day, but I would never go there at night. We found the clinic and met with LaRon, who is running the study. We thought that we were going to be recruiting young moms to participate in the focus groups but LaRon informed us that they had been having trouble getting enough people, so they've hired a full-time recruiter. That was a big relief to me, since walking up to teenage moms in the street and asking them if they'd like to come talk about their sex lives didn't sound like much fun. So Elspeth and I just got a tour of the STD clinic, which is a cool nurse-run free clinic that offers a lot of really good services for free. He then gave us the software and stuff we would need to do transcription and emailed us the audio files of preliminary group sessions so that we could get an idea of what to expect. I started listening to one last night and transcribing it is going to be hard work. First of all, it's hard to understand what they're saying because of the way the talk and all the slang they use. Secondly, they all talk at the same time, and they have their kids with them to scream in the background. I'm one of the people transcribing next weekend, so it'll be very interesting to see how well I do. At least I don't have to recruit, but it'll be slow going.

Today I'll just be hanging out at home finishing up a lot of minor chores. I'll edit my genetics paper, do some laundry, maybe some baking, finish listening to those audio files, sew patches onto my scrubs, and maybe get to the assignment that we already have for our next class. It's not due until Wednesday though, so I'm not terribly worried. My schedule looks pretty manageable next week, it's the following week that things get crazy with the beginning of clinicals.

Three down, one to go

But first, because I know at least some of you really want to see it, check it out. There's something funky going on with the pictures right now, but that will probably be fixed soon. Sarah's up there too.

I've now finished with Nursing Science (thank goodness), Pharmacology (actually sad about this one), and Genetics. Well, I have to write a paper for genetics, but I can do that tomorrow. My last final exam will be Health Assessment, tomorrow at 8am. I don't have to do anything at all on Friday, and Saturday I'll be recruiting for my condom-use project. Then a whole new class starts up on Monday.

The new class will be nice because we'll only have to focus on one class, but it's going to keep us busy. The syllabus is already online, and the workload looks pretty hefty. Plus there are clinicals associated with this class. I'll be here for 3 shifts (one week), and then at Strong Memorial Hospital (across the street from the nursing school) for the following 3 weeks in an acute care unit. There are about 6-7 students in each clinical group, and I know a few of the ones in mine pretty well. I actually get to pull out my scrubs now and use them for the first time. It's pretty exciting, but also terrifying.

Now it's time to go do some reviewing for tomorrow's test, and maybe watch a movie before bed. I'm liking this free time thing.

Fun holidays

I got a real break this weekend. That's why I haven't updated, I've been too busy having fun. I haven't had class since Wednesday and I've been thoroughly enjoying myself all this time. Here's a brief summary of my long weekend:

Thursday: Be Lauren's patient for her final demo. She did a great job, and I managed to not giggle too much. Then I went to the gym, did some homework, baked some muffins, watched a movie, and just relaxed all day.

Friday: Went for a ride with Bernie and another friend of his. Can't remember the friend's name, but it was a nice long ride. I was pretty tired by the end, since I had done a lot of riding throughout the week. Post-ride I took a little nap and then went out to Sarah's for a 4th of July BBQ. It was almost all people that I'd met before, including Paul, the tall geeky guy. Everybody had a great time, and I spent most of the evening with 2 year old Yasmine on my lap trying to convince her that she could only hold one piece of watermelon in each hand and should eat what she had before trying to grab more. That was only somewhat successful, but I've apparently become one of her favorite people, second only to Paul. When she wasn't sitting on my lap she was busy splashing around in the kiddie pool or trying to help her mom feed Maya, the nearly one year old. Besides the time playing with the little tiny people, I did manage to have real conversations with the adults too. I even got to talk to Paul for a while. Sarah tried as hard as she could to get us to go watch the fireworks, but that didn't work since he seemed unwilling to offer me a ride and I was too shy to ask for one. So after everyone else had gone home, Sarah, Ronen, Paul and I all stuck around and chatted until almost midnight. I found out that they play Settlers and other board games, so maybe there are board game nights in the future. I think the BBQ thing is starting to get old, so Sarah's going to have to come up with other ways to try to throw Paul and I together.

Saturday: Lot of grocery shopping, a pathetic attempt at homework, and then headed over to Katherine's house for a Wii party. I'd never played on a Wii before, so this was very exciting. Turns out I'm a very good Wii boxer and have excellent balance on the Wii Fit, but can't hula hoop to save my life. Wii Fit is really fun. It's a questionable workout, but it at least gets you moving and is very well designed. There's even a little step aerobics game that works like DDR. After we'd had our fill of the Wii, we baked some cookies and watched SNL. Then we all found beds to sleep in (it was a sleepover Wii party) and were out for the night.

Sunday: I woke up and got to watch the second stage of the Tour de France live. It was pretty good, though nothing unexpected happened. Then we went to the kitchen for breakfast and about halfway through my bagel I started to feel really light headed and nauseous. I had to go lie down for a while before it cleared, and even then I couldn't move much without getting waves of nausea. I have no idea what was wrong. I'm feeling mostly okay now, so hopefully it was a weird fluke thing. I'm probably just fighting off a bug and all the stress from school was a little too much for me. If it happens again I might go get checked for anemia or something, because I've had some minor problems with low iron in the past. I ended up staying at Katherine's until about 5pm, working on my Nursing Science essay and a few other things. Now I'm sitting at Panera trying to finish that essay, but obviously getting a little distracted.

Here's what's in store for next week:
Monday: Review session for pharm test
Tuesday: Pharm test
Wednesday: Nursing Science test
Thursday: Health Assessment test
Friday: Nursing Science essay due
Next Monday: Genetics essay due.

I don't have any classes after 9am Thursday morning. And then my new class, Therapeutic Interventions starts next Monday. That means that if I can get my genetics essay done quickly, I can have the whole weekend free of homework. That sounds too good to be true.

Happy Canada Day!

So far my favorite quote from any professor: "If you can't handle the hands-on stuff, go to medical school."

Not a lot is happening besides school. Next week is basically finals week. We're finishing up all the current classes and switching to Therapeutic Interventions and clinicals. I'll also be starting my Fuld Scholar project next week. I may be going to help with a focus group session on the 11th, and will otherwise be working on transcribing the sessions and possibly recruitment for the sessions.

I've only got one more day of real class this week and then I'm done and can work on my final papers and studying. Thursday I only have to be a patient for Lauren's final demo. I'll probably get a lot of riding in since I have so much time off. Except that I'll be going to another BBQ with Sarah's family, this time at her house, and a Wii party at Katherine's house. Such a busy social calendar.

Right now I'm exhausted and need to fall asleep. Good night!

Weekend report

Saturday was sort of a non-day for me. I slept in, a lot, got myself up and moving way too late to go to the public market. Puttered around doing nothing, cleaned my room, finally got home from my shopping at Wegman's around 6:30, and then sat around and polished up my clinical paper for Pharmacology before going to bed.

Today, on the other hand, was a little more eventful. I went for my first ride with my new heart rate monitor. There's a post about it on my other blog. After I got home I went out to a BBQ with Sarah and family at the house of some of her friends. The original purpose of the event was to have me meet Sarah's friend Paul, but that luckily got somewhat diluted by the fact that today was the final of the European soccer championships and all of the men invited wanted to watch the game.

Sarah and Ronen picked me up around 2:30 and we arrived at the friends' (Eric and Nancy) house about 15 minutes into the game. Sarah and Nancy quickly disappeared with all the small children (there were three of them) to the backyard and I stayed with the guys to watch the soccer. It wasn't a terribly exciting match, but it was still fun to watch. By the time it was over we were all really hungry, so Eric cooked up the burgers and we got all the food laid out. The difference between a BBQ with my friends in Portland and a BBQ with this crowd is quite striking, and entirely the fault of the three girls. Everything revolved around the kids, which doesn't make it less fun, just a completely different experience.

I actually got to talk to people a little bit more over dinner, including Paul. He's an interesting guy, and fun to talk with. Obviously a little bit socially awkward, but not too shy so between the two of us I managed the social graces and he managed to keep the conversation going. He's an optical engineer, currently has a torn hamstring, and seems to play every sport known to man. He's also well over 6 feet tall, probably late twenties, a total geek, and completely adored by the three little girls (he makes remarkably good animal sounds and they love him for it). Basically, he's exactly my type. Except for the Catholic thing, but that didn't come up at all today.

Since Sarah is the most blunt and direct person I have ever met, she of course asked me on the way home what I thought of him. I'm sure she will be asking him the same thing about me as soon as she gets the chance. It'll be interesting to see what, if anything, happens next. I can tell that Sarah is loving her role as matchmaker and I am sure that if she gets any encouragement from him at all she will make sure I meet him again.

Regardless of the whole Paul thing, I had a really good time playing with all the little kids and meeting some more friendly people today. Tomorrow I will be going for a bike ride with another classmate, Elspeth, and taking a pharmacology test. I'll have to try out my heart rate monitor again. Yay for new toys!

Birthday, demo, and babies, oh my!

I had a very good birthday. At the beginning of class yesterday morning, one of my friends wished me a happy birthday, which the turned into a big exclamation of everyone sitting around me saying, "It's your birthday?" and, "You're doing your final demo on your birthday!?" The outburst was loud enough to make sure I was bright red and everyone in the class knew that it was both my birthday and my final demo day. At least they didn't all burst into song.

After class, my partner Lauren and I went over to the lab to do the demo. I didn't know who would be evaluating me until I walked in and when I saw my two favorite professors (both named Pam) there, I was extremely relieved. Then I picked my randomly assigned system and got musculoskeletal. Yikes. Anyway, I just went on autopilot and must have done a pretty good job. Apparently at one point during the demo one of the Pams looked over at the other and whispered, "She's really good!" and the other replied, "Yeah, she's my student." Lauren did a good job at not giggling when she saw that. She actually did a very good job of not giggling at all during the whole demo. I managed to finish in 20 minutes, which had me scared because I thought I must have missed something, but I don't think I did. After I was done the Pams went off by themselves to discuss and after what seemed like forever they came back and talked me through what I could have done differently and what I did particularly well. They were both very encouraging and assured me that as the first person to do one I had set the bar pretty high. I'm very happy about the feedback that I got, since bedside patient care is the one thing I have almost no experience with (at least with strangers).

After the demo I went back to the student lounge and got mobbed with congratulations, birthday wishes, and questions about the demo. Sarah, of my newly adopted family, brought me an angel food cake with strawberries and whipped cream and it disappeared in about 10 minutes. It was delicious, and really nice to have my traditional birthday dessert. I spent the next 2 hours in the lounge talking to people, mostly about the demo. It was eventually time to go to class, and we all reluctantly filtered out to listen to a lecture on renal disease and diuretics.

After pharmacology, I was planning to head home and just relax until the usual Thursday class pub night. But, Sarah invited me over to play with her babies (Yasmine is 2.5 years old, Maya is almost 11 months). I couldn't say no to that, so I went and we had a lot of fun just hanging out and talking and playing with the two adorable little girls. Eventually Ronen, Sarah's husband, came home and he joined in the fun. We had dinner, went for a walk to a playground, and generally had a great evening.

At that point it wasn't worth it for me to go home, so I just went straight to the pub to meet other friends. Once again I got bombarded with happy birthdays and final demo questions. A couple of others had done their demos that day too, so we were all being congratulated and interrogated.

I got home around 11:00pm and finally had the chance to open my packages that I'd been waiting to open so patiently. Inside I found a heart rate monitor (Yay!!!!), a really good bike light (which I've been needing), a 4GB flash drive (very useful for school), and a beautiful big poster of a bike race. I was so excited that I wanted to play with the HRM right away, but had to get up for lab the next morning and decided I could wait until the next day. Oh, I also got a voicemail rendition of Happy Birthday that was left while I was taking a shower. I think the performers could use a little vocal training, but I'll give them the benefit of the doubt and blame it on the phone.

This morning I went to lab, and offered myself up as guinea pig for Lauren and Laura to practice their final demo stuff on. I had to leave early to get to a meeting for my Fuld Scholar research project. I'm going to work on the study about condom use decision by young black mothers. Apparently these girls, when asked about their sexual partners and contraception, don't include their "baby daddy" among their sexual partners, even if teir still sleeping with him. For some reason, he is given a different status in their minds and their more likely to take risks, like not using a condom, with him than anyone else. So the study is done by the county health deparment and their getting these young mothers (age 15-19) to talk in focus groups about the decision they make regarding sexual risk-taking and why. I'll be mostly involved in transcribing the focus group sessions, which I think will be very interesting. I'll also have a chance to do some recruitment and maybe help with the logistics of the focus group meetings. I'm really looking forward to it, although it will add a fair amount of work and stress to my life.

Now that I'm done with classes for the day I'm trying to work on a paper for pharmacology. It's not really started yet, but I should be able to get most of it written this afternoon if I don't procrastinate too much. I'm at my coffee shop, which usually helps me focus on schoolwork. Now that I'm finished checking email and updating everybody on my exciting life, I can get back to it. Thank you to everyone that sent me cards, presents or happy birthdays!