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.
Tuesday, November 18, 2008
Thursday, November 6, 2008
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 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.
Saturday, November 1, 2008
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.
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.
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