Brain Scramble

Today our professor informed us that two days before class started, she was diagnosed with breast cancer and has since (in about seven weeks) undergone four surgical procedures. She didn’t cry, but she choked up and quickly left the room after the announcement, while the rest of us sat in stunned silence. It was very moving. Here is our hard-as-nails professor baring her soul to us, a bunch of students who were just trying to “get by.”At the beginning of the class, we were all first terrifed by her demands, and then irritated by her tough exterior and seemingly unavailable attitude. I’m pretty sure after class today, we all felt like shit. I know I did. Although I never said anything too horrific about her, I definitely did my share of commiserating and begrudging. Now I feel horrible, knowing what this woman must have been (and still is) going through. Without ever knowing about her diagnosis, I had noticed her softening up towards the end of our class, but I never knew why. Now I understand that this kinder, softer, more human person is the real instructor, and I wish I would have taken the time to get to know her even at the beginning of the class.

So, in honor of my instructor, I joined the American Association of Critical Care Nurses (AACN) tonight. Previously, I had asked her to recommend some reading for my upcoming ICU internship, and she suggested that I join the organization while I could still get a good student rate, and read their journals. I’m taking her up on it, for one, because I want the journals, for two, because I believe these organizations generally do good in terms of promoting the profession, and three, because it’s my way of honoring this professor who really did her best during an incredibly tough time. I have the deepest admiration for her tough exterior. Did I mention she did an oncology lecture with no sign of breaking? Sheer will.

So. Today was one of those days that I’ll probably remember for many years. I know for sure that the lesson was that important. And she immediatly became one of those professors that I’ll probably remember, too, although I think I would have remembered her anyway because she taught the critical care course that I loved and hated, and also briefly became the personification of all those “anti-new grad in the ICU” attitudes. (However, by the end, she stated that she supported my own plight, and even at the time, I felt very flattered.)

I speak of this woman as if she’s already died. Sorry to eulogize. I have no idea what her prognosis is, but I think her fight deserves some recognition. She was such a mixed bag for me before I knew of her diagnosis. A love-hate relationship that, in a few weeks, had really developed into a deep respect and better understanding, on my part. And then she dropped this bombshell and I just don’t know what to think. But I was frequently impressed by the compassion that seemed to flow from this woman. You can hear it in her lectures. She knows what good nursing is. She’s the advocate you want by your side if you can’t speak for yourself. I hope she has someone to stand by her side when things get tough, too.

I’m not a religious person so I can’t say that I’ll pray for her. But this woman will be in my thoughts as she battles this thing. I hope she knows she’s changed me.

I’ve been quiet on here lately because at this point, I’m just trying to get through Med Surg II alive. Each day puts me one day closer to the summer and my SICU internship. Really though, each day puts me one day closer to being done. With class. With school. My classmates and I have definitely been feeling the burn in terms of school and we are all quite ready to be finished. What a far cry from less than a year ago, when I first started, and couldn’t have been more excited to be going back to school. My, how things change…

In fact, yesterday in class, we had a discussion about backflowing IV tubing to check for drug compatibility. As recently as a couple of months ago, I would have had no idea what anyone was talking about. Hell, it took me at least an entire clinical rotation, and possibly more, to really understand the concept of just priming the tubing, let alone any fancy tricks. Now we toss around nursing slang and lingo like hot potatoes. We are certainly a different group of students. We were so green and naive when we started in June. Yet we’ll be green and naive when we graduate this December. So what happened in between? Something. I just don’t know what.

I had another miserable week in clinical last week. I had a nurse who completely ignored me. I found myself in the OR again, hoping desperately that it would be a better experience. Sadly, I found myself being yelled at again and when I relayed the info to my clinical instructor, she insisted that never in three years had she ever had a student complain about the OR. I’m so over her, although I am trying hard not to see things in black and white. There are things she is very good at, even as a clinical instructor. She’s a very good technical nurse, for example. And she’s also incredibly patient while I fumble around trying to hook up IV tubing. She just sucks at sticking up for her students. Oh well. In a way, I’m glad this rotation sucks because now I have my bad rotation out of the way, which means my senior practicum simply has to be good. So there!

I’d like to take a minute to talk about nurses who ignore their students. This strikes me as exceedingly dangerous. Last week, my nurse hadn’t charted once on my patient all morning. She relied completely on my assessment, and basically assumed I’d be giving all the meds with my instructor. I guess this is okay when the patient is stable and independant, but what would have happened if that patient had suddenly gone south? How would she have known what was going on? This frightens me. I am still a student, after all, and I have definitely screwed up a few times. I guess I feel that I’m not really willing to sacrifice the license I worked so hard on just because I was too busy to deal with a student. I mean hell, even if you don’t want to deal with a student, it would seem highly questionable to not even look at the patient. Odd. These things confuse me.

On a final note, I have begun the process of spending my as-of-now imaginary summer salary. I’ll actually be making better money than when I worked in Corporate America (minus benefits of course,) and based on our personal financial decisions, I’ll get an entire month’s worth to play with before I have to start putting back into savings. I am pretty sure I’m going to buy a new pair of running shoes because my current pair is two years old and my crabby ol’ knees just can’t take it anymore. I’m also toying with buying some kind of geekery; an ungraded MP3 player for my long bus rides. Something that plays video. I’m afraid (and also not hip enough) to go Ipod, but that would make the decision very easy, wouldn’t it?

Anyway. Onward and upward. I’ve got a care plan to write. Everyone have a beverage of choice for me on Tuesday; it’s my last day at this miserable rotation and I move onto bigger and better things!

Have a great week, friends.

I got an awesome internship this summer! And I am SO.FREAKING.STOKED.

Without saying exactly where the internship is, I can tell you that it’s a fantastic oppportunity and I feel really honored to have been selected. I literally yelled in the guy’s ear when I got the phone call. He’s probably deaf now. Oh well. At least he knew how excited I was.

I’ll be working full time in the surgical intensive care unit with a preceptor, taking care of patients in basically every way, including dealing with physicians and family members. After the summer ends, I am expected to complete one 12-hour shift per week as a CNA untilI graduate. For the summer, it’s basically 400 hours of precepted clinical experience and possibly some classes, too. I mean, what an amazing opportunity!

Amazingly enough, I also got another job offer from a different place in the city. When I told them I had already accepted an internship in another ICU, they called me back immediatly and asked if I would reconsider if they could get me an interview with one of their ICU managers. I admit that I felt (and still feel) like a complete and utter bad ass. Someday, my luck will wear off on me, but as of now, I am enjoying every bit of it. However, this internship that I’ve accepted is a much better deal; for starters, it pays significantly higher. But most importantly, it’s precepted nursing experieince, whereas the other hospital, by their own account, gives out mostly CNA responsibilities with a few additional skills (IVs, blood draws, foleys, etc.) In the ICU, I’ll have 1-2 patients that I’ll provide full care for. At the other place, I would have had 9 patients that I would be basically doing vitals and baths on all day.

Not that I have anything against CNA work. In fact, in my current clinical, I like the CNA better than all the nurses, and he has been incredibly helpful to me. Sometimes I want to hug him, actually, because he’s the only nice person there. Additionally, I am not above saying that I can always use more experience gathering vitals and giving baths, but being officially precepted in an ICU is just far to beneficial to pass up. Also, in the last four years, they’ve (this particular hospital) hired all but 1 of their summer interns (this summer there are 4 of us) after graduation. This happens to be the hospital where I did my med surg I rotation, and I absolutely loved the population and have been trying to devise a way to get hired there ever since. Now I just have to hope that all goes well and I don’t kill anyone.

Other benefits? The pay is great. I get a chance to earn a decent amount of paid time off to be used during the fall semester if I need to study or something. I take classes within my specialty area. I think I already mentioned that I’m precepted instead of being a CNA. It’s an awesome patient population. And if things go well by both parties’ standards, I could get a job there when I graduate.

I think, however, the most important benefit is the stuff I’m going to learn. As a new grad in the ICU, the learning curve is HUGE. I am going to have a chance to decrease that curve before I graduate, thereby decreasing some of the stress that I’ll have as a new grad. (HA, yeah right.) I’ll be a student, there to learn, and by the time my senior practicum rolls around, I’ll be miles ahead of where I was before.  I can’t wait to see the changes that occur in my practice this summer. It’s going to be busy; I’ll be working 40 hours a week at the internship, plus I have a clinical (mental health) on top of that, which gives me 55-60 hour weeks for about a month and a half. No matter. It’s temporary and I know I can get through it. I just have to remember to keep my ears and eyes open all the time, to be a sponge, and remember what an amazing learning opportunity I’ve been presented. I can’t wait to start. I can’t wait to learn. I want it all now. Each miserable day I have left in Med Surg II will bring me one step closer to this awesome opportunity.

Anyone have any suggestions on what to read/how to prepare for summer in the SICU?

Wow, thanks, you guys.

When I wrote the post about my bad experience with the patient advocacy scenario, I had no I idea that I would receive such an outpouring of support from my friends in blogland. Your responses really touched me, and also helped me move on. You allowed me to remember that there are folks out there who give a crap, and doing what’s what doesn’t always mean doing what’s easy. That meant the world, and I thank each and every one of you for the lessons you taught. I have been able to move on and I now look at the whole bit as incredible lesson in practice. I will carry the experience with me for the rest of my career, but now I am able to focus on having other great learning experiences in the clinical arena. So again, thank you so much for your support. It really means the world.

Onward to this week’s episode of “Why Does Everyone Hate Me in Med Surg II?”

Just kidding.

Well, not about the onward part. But I just haven’t been having an easy time at this hospital. I don’t believe it’s retribution from getting myself in hot water last week because the other students are facing the same issues. The bottom line is that on this floor, the nurses don’t like students. It’s a teaching hospital, so the fact that this is slightly unacceptable behavior could remain unsaid. (But I specialize in saying the unsaid out loud…) My first nurse this week was just incredibly cold towards me and the other students. My nurse yesterday was inpatient and obviously irritated at everything I did and every question I asked. I wrote previously that the nurse really has the power to make or break the clinical, so in that facet, this rotation gets a big fat “F.” At least I’m halfway done.

But the patients are still making my day worthwhile. I’ve had lots of interesting ones, and I’m enjoying working with two at once this time around. I had a woman with meningitis, a guy with a big butt wound, another in renal failure, another in non-responsive state from an assault. The latter has been the most interesting for me, as he went into respiratory distress and had to be transferred to the ICU at the end of my shift. In a way, I felt somewhat responsible for his decline, because I felt I didn’t have the experience to be able to spot what was happening, and I wasn’t sure if my nurse was keeping an eye on him behind me. I got over that feeling pretty quickly, because there were actually lots of people involved in his care who saw it happening and besides, sometimes you do everything right and you still can’t prevent it. It was an awesome experience to be able to witness what happens to a person when they go into respiratory distress (in this case, I found out that he had a PE.) I think now that I’ve seen it once (the dusky coloring, the diaphragmatic breathing, the increasing and unresolving tachypnea and dyspnea) I will know exactly what’s happening next time. One great lesson down. Check.

My other patients were also interesting, including the guy who insisted on calling me a “Bull Shit Student” because “B.S. Student” happens to be embroidered on my school scrubs. He told me jokes all day and pulled a couple of pranks on me. Loved him. So, despite the crabby nurses, it was still a good experience because I was still dealing with the patients that I loved. I am firmly convinced that I’ve learned something unique with each and every one of the patients I’ve dealt with. That’s why I keep coming back.

I encountered a situation during my clinical yesterday, and I defintely underestimated how upsetting it was. I figured that after blowing off steam with my family and stuffing my face with ham pizza, I would feel better about it. Unfortunately, I was awakened from my normal clinical-induced coma at 5:00am on my day off, feeling very, very angry. Not only do I strongly dislike waking up angry, I hate it even more when it’s 5am and I should be sleeping until noon. I also have been in the process of establishing a rule for myself: I can let things that happen at work affect me until I go to bed at night, and then it’s over and time to move on. Preferably, I want to be able to mostly let things go by the time I get off the bus on my way home. It is a way I have been trying to establish some boundaries, but last night it just didn’t work. I was and probably still am, really upset. I joked with my Mom that I was going to write a 12-page blog post, but now I realize that I might. DOH.

So where to begin? I don’t even know. FYI, basic details have been changed for HIPAA reasons, but I’m giving you the basic idea.

I had a young patient (20-something) who was going to surgery for a pelvic fracture that he sustained in a car crash that also killed another family member. By the middle of the morning, there was no word on his surgery, his pain was starting to get out of control since we couldn’t give him anything by mouth, and his mother was getting pissed. She pulled me aside and immediately broke down sobbing. After that, I called the OR, and they gave me almost no information except that it was going to be a few hours. That, in and of itself, was irritating. Throw me a freakin’ bone, OR peeps. Anyway, the situation continued to escalate, the mother continued to pull me aside and let me know that she was getting angrier and angrier, and basically nothing continued to be done about this kid’s pain.

Side note: We are supposed to be working almost entirely independantly in this rotation while still keeping our “precepting” nurse aware of all situations (The word “precepting” is evidently a joke at this hospital but that’s another discussion, and I’m used to being abandoned so I’m over it.) Of course, not having access to the computer system (i.e. all orders and meds) makes that whole “independence” thing slightly difficult. So gist is that every time my patient needs pain medication, I’m completely helpless except to tell the nurse, over and over and over and over again.

A few minutes later, the mother pulled me aside again. She said that she was concerned that the hospital was pushing back the surgery because they don’t have insurance. At this point I realized that her level of frustration (combined with lots of grief from a whole run of bad luck) was beyond something that I could handle as a student nurse. I told her I was going to do a number of things to help the situation along, one of them being that I would put her in touch with a patient advocate who could help her better than I could.

In the meantime, no one (other than myself) has explained a damn thing to the family about the surgery or anything else, the nurse is no where to be seen, and the poor kid has waited over 40 minutes for an IVP of morphine. I know, because I charted exactly when I asked the nurse to get his meds. (Lucky for me, I charted my ass off yesterday.) If you waited 40 minutes for a hamburger at a restaurant, you probably would have left by now. Instead, he’s stuck in bed with no where to go and no surgery to fix him, complaining of climbing pain.

At one point my clinical instructor told me that the reason the family “picked on me” and “didn’t like me” was because I was just a student. I had to take a moment to pick up my jaw from the floor. Apparently at this hospital, a family who “doesn’t like you” will cry in your arms and beg you for help.

Following up on what I told the family I would do, I went straight to my nurse and explained the situation. I told her (and this is an important piece) that I was going to call a patient advocate and would she mind doing the social work consult for me? She did it immediately (although it took her 45 minutes to deliver pain meds.)  I walked away and called the patient advocate.

This patient advocate arrived less than half an hour later, and the first thing he did was thank me for calling him. I felt good that the situation was going to be resolved, and walked off.

Twenty minutes later, I get called to the nurse’s station. Standing there is the patient advocate, the charge nurse, the director of the OR, and my clinical instructor. For the next five minutes (although it seems like a freakin’ eternity) I was publicly chewed out by the director of the OR  for calling the patient advocate, who now stood next to this woman shaking his head at me. (A far cry from the reaction I got when he first came to the floor and thanked me for calling him.) The director told she didn’t have “time to be coming up to the floor and dealing with this stuff.” (Excuse me? You don’t have time for unhappy patients who are having surgery and haven’t been communicated with?) I was told over and over, in front of basically every nurse on the unit who happened to be walking by, that I screwed up. Apparently I should have told the charge nurse about the situation first, instead of going straight to the patient advocate.

At one point, even my clinical instructor screwed me when she made a statement about “in defense of myself, I wasn’t aware of the situation.” Well guess what? My nurse was and my nurse could have stopped all this, and my nurse was no where to be found. I felt completely humiliated and furious. I was thrown to the wolves for advocating for a patient, and not even my clinical instructor would stand up for me.

But I held my tongue. Why? Because I’m the student nurse and this is a learning experience. I took full responsibility. I apologized for inconveniencing everyone. I thanked them for teaching me. I even shook their freaking hands after they hung me out to dry. And I walked around with a smile on my face for the rest of the day, even though the charge nurse continued to scowl at me, and every other nurse who had witnessed the attach avoided eye contact.

Two hours later, my patient went to surgery.

I encountered even more hostility in the OR area. The charge nurse screamed “where the hell have you been?” when I went to get my OR scrubs. I was pretty sure everyone on the surgery team knew what had happened. They all stopped talking when I walked in the room. It was incredibly humiliating. And I hadn’t even done anything wrong.

Aside from the poor nursing I witnessed (in the PACU, his nurse refused to scratch his leg because “we don’t do that here” and then walked away mumbling “jesus christ…” under her breath) I was really astonished at the lack of communication and the complete lack of teamwork demonstrated that day. A measly student nurse poked a hole in one of their policies, all for the good of the patient, and no one came to the defense.

Words cannot even explain the incredible anger I feel towards this hospital, employees, and the whole situation.

The saving grace in this story is my patient and his family; they are truly what is enabling me to see the good in the situation. When he woke up from surgery, he said “Caroline, can you hold my hand?” Tell me, does someone who thinks you’re “just a student nurse,” as my clinical instructor put it, say that? The family confided in me. Cried to me. And in the end, I know that I did exactly what was right for them, even though no one else in the damn place would stand up.

Yesterday I was not a student nurse. I was a nurse. I was an advocate. And that is my job. I can place IVs and foleys and do blood draws and pass meds. I empty bed pans, bring clean linens, do assessments. But yesterday I got to do more than that, and I realized that as humiliating as it was, I left that hospital knowing I did everything right and that I’d do it again in a heartbeat. When that family leaves the hospital in a few days, it will be me they think of when they recount the situation. It will be me who changed things for them, who let them cry, who honored their needs, who didn’t judge. It will be “just a student nurse.”

And that is what it’s all about.

I am officially a med surg II student. Doesn’t it seem like yesterday when I started this blog and was wearing my stethescope backwards? Good lord. Now I’m supposed to be taking full responsibility for not one but sometimes even two patients. Our instructor seems cool; she has stated on numerous occasion that while she will always be there if we need her, she does not hold hands or babysit. While a couple of the students are a little nervous about this, I’m doing okay. The reason? You may or may not remember that I had a relatively bad preceptor when I did a rotation in the NICU. She frequently left me  completely alone on the floor, in charge of a very sick, very small person. Now I’m reaping the benefits from that kind of forced independance. Once I made it through and survived the rotation without killing anyone, I started craving independance, especially during OB. Now, apparently, I’m “old” enough to expect it, or rather, have it expected of me. I’m okay with that.

Don’t get me wrong; I’m not saying I’m 100% confident in all that I do. In fact, I feel a little rusty. It’s been a long time since I’ve taken care of sick adults. The last time that happened was med surg I back in November, and that was a rehab floor, and I could barely do vitals without having to quadruple-check myself. In between now and then was infants, mothers who weren’t sick, and several weeks of vacation.

Anywho.

The hospital I’m at now seems to have a real thing against new grads in their ICU. We all got “the talk” several times today, from various people, including our clinical instructor. She happened to mentioned that she was “pleasantly suprised” that only one of us mentioned that we wanted to do critical care when we filled out our self-evaluation form that we do before every clinical. Em. That one person was me, and apparently everyone knows it because they all stared at me. Ah well.

The thing about it is, I’m kind of like a child. Or rather, a very obstinate teenager. The more someone tells me I can’t go into an ICU, or that I shouldn’t or that it just wouldn’t be prudent or why not learn to be a nurse first, the more determined I am to get a decent ICU gig. I have this little thing called an ego, and it loves to prove people wrong. A surefire way to get yourself proved wrong, with me, is to tell me that I can’t. No lie.

Besides the clinical instructor at the hospital, our current class instructor loves to regale us with scary stories about critical care. I admit that she makes me nervous, and I’d be lying (and also very cocky…like, moreso than I already am) if I said I hadn’t second-guessed myself at least ten times in her presence. But she won’t scare me off. The problem is this: that was thirty years ago. Things are different now; they have to be. One student (who plans to start in med surg and is adamently against my position) said she thinks just because the market has forced this change doesn’t mean it’s necessarily a good one. I think she’s right, but it doesn’t necessarily mean it’s bad, either. While new grads in ICU is a relatively new phenomenon, it ain’t that new, and I bet you could find lots of people who were glad they started there. Certainly not all ICUs would be good for new grads, especially the ones that don’t offer pretty sound GN programs. But I’m not willing to rule it out entirely based on the probability that something might not be perfect.

Nursing is held as one of the most flexible careers in this country. People spend thousands of dollars on education just so that they can work three days a week, and experience all the opportunities available in this field; nevermind all that compassion-crap. In the wake of all that, I think we’re doing ourselves a disservice to completely rule out the idea that no new graduate is appropriate for the ICU. Is it for everybody? No. Is it easy? No. But neither is any field of nursing. They all have their struggles.

Let’s stop all this old-fashioned pigeon-holing and accept the fact that times have changed, and so has nursing.

P.S. Just because I want to go to ICU doesn’t mean I have anything against med surg. People always assume that. Don’t.

I got my first rejection today, from one of the hospitals I was trying to get an internship at, and wow, it really pissed me off.  There’ll be no more of that. :::stomp:::

I have basically let go of my anger, but I’m still hanging on to some slight bitterness. The thing is, their interview process, in my opinion, is crap. (Remember: I’m bitter.) Basically, they have hired this company to interview every single candidate with the exact same set of questions, to get an idea of the candidate’s “strengths.” I was instructed to be as honest as possible because really, there isn’t a right or wrong answer to any of the questions.

I have a degree in psychology and I know that’s crap. There are, in fact, wrong answers. It’s just happens to be slightly more difficult to figure out what they are. Now, because of my background, I am aware that they are playing games, but even so, I tried to be as honest as possible with all of my answers. I wanted to sound human; slight flaws, and all. Yes, there were a few times when I felt the need to pad my answers or give the interviewer a lovely pair of rose colored glasses, but I was never dishonest.

The questions were things like “do you smile often?” (er, average, I guess) and “do you play games at work?” (only with people’s minds) and “what have you done in the last 24 hours that was productive?” (bled out of my ears trying to learn how to read an EKG strip.) And the interviewer (who does 30 of these a week and yes, I asked, maybe that was my downfall) transcribed every single answer onto paper. I sound like crap on paper!

That was last week, and today I got my rejection via email. Hrumph. I admit that I was at one point, in complete denial. I literally thought, “surely it was an accident! They didn’t mean to send that to me.” I was sure the recruiter would be calling to apologize for her mistake. (Aren’t I cocky?) I felt a little bit like I felt when I got rejected from graduate school. A strange combination of irritation, anger, deflated self-esteem, and total apathy.

My husband told me that it’s much harder to get an internship rather than a job, because it’s a lower-paying, menial position with tons of qualified applicants, whereas RN positions may be different based on the number of people who are actually qualified. I hope he’s right but more than likely, he made that up and is just trying to make me feel better. In the meantime, and in the name of rationalization, I have this to say:

I cannot stand being boxed into a psychological profile. The thing I love about nursing is that I never know what kind of weird, annoying person I am going to have to deal with; a weird, annoying person that may or may not fit exactly into a psychological profile. One of the reasons that I got out of psychology was this fact. I couldn’t handle being involved in anything that tried to box someone in, without any exceptions. Human beings are walking exceptions. When I got rejected from grad school, it was based on test scores and an essay. They never spoke to me. And besides feeling kind of, well, insulted, I let it go pretty easily. So in the case of this particular internship, if they had interviewed me legitimately and then decided I wasn’t a good fit, so be it. But a transcribed, pre-written, one-sided interview with no feedback does not tell you who a person really is. I’m kind of sorry that this hospital bases their hiring process on this type of stereotyping.

I’ll probably still apply to this hospital for an RN position, but next time, I’ll be more prepared for their fake, first interview process. In the meantime, I’ll paper bomb the rest of the city in hopes that I can come up with another summer opportunity.

I’m a relatively smart person, and in the past week, even I have discovered a whole new respect for ICU nurses.

We just started Med Surg II and apparently, it’s a critical care course (although our clinical hours will be spent on a med surg floor.) The last week has been spent learning about ventilators, ABGs, and EKGS. My brain hurts. My brain is scrambled.

Our instructor has a buttload of critical care experience and she gave us a “Come to Jesus” talk about new grads in the ICU. I admit that she was able to terrify me for more than just a second. But I still feel like I can handle it. I just know it won’t be easy.

In the meantime, I have done more studying in the last two days than I’ve done since my very first semester in school last summer, and there’s more to come. After a four hour lecture on EKGs, I was so completely confounded that I didn’t even have the words to verbalize my own questions. I had to pause strategically while talking so the instructor could fill in the blanks as we went along. And last night, after spending 5 hours on ABGs and nursing priorities, I went to bed only to wake up at a  3am wondering if I had put oxygen as the first or second priority on of our homework case studies. (For the record, I had put it as #1.) Stupid respiratory alkalosis. It’s happening…

But on the other hand, it feels good to be applying this stuff. I admit that I was starting to think that nursing school was going to be a breeze. Not so. This class is going to be my challenge, but it’s an important one. If I want to go into critical care right out of school, then I feel that this class will help me prove to myself that I’m ready for it. Not ready in the sense that I’ll be able to take a full load of patients immediately. But ready for a challenge, ready for it not to be fun all the time, ready to spend hours and hours wracking my brain for an answer, and ready to accept that sometimes there are none.

After I finish my critical thinking case studies, I feel like I’m on a runner’s high. (And they ARE actually critical thinking; it’s not just complex concepts. It’s complex concepts applied to people with lots of co-morbidities.) Something about working the brain really hard just gets me going. If that’s what it’s like, then I know it will be okay, in the end.

ICU, here I come.

1. Our clinical instructor doesn’t make us come the night before for our clinical assignment because she wants it to be more like the “real world.” hip hip hooray

2. She gives us hour long lunches and sends us out of the hospital because we’ll never be able to do this again. hip hip hooray

3. She doesn’t make us write med cards as long as we can prove (verbally) that we are familiar with the drug. hip hip hooray

4. (Bonus) She is the charge nurse on the floor we’ll be working on, so she knows all the nurses and which ones are good with students. hip hip hooray

So, all in all, I’m expecting this to be a good clinical rotation. I do wish the classwork would just go away, but at least I only have to put up with it for a few weeks. They have also decided that we will be doing our patient simulations in groups of FOUR. That’s right. FOUR. Since when do FOUR nurses work together on one random patient? :::hrumph::: Additionally, they scheduled our times and pre-picked our groups, so not only do I not get to work with my friends (their words, not mine) but I also end up missing my niece’s first birthday which I had been planning for several months to attend.

I’ll bet there for sure next year.

Med Surg II, here I come.

I’m inserting myself into this debate.

Keep in mind my background: I’m a second degree student in an accelerated BSN program. So yes, I have my biases.

The first point I’d like to make is that as much as I would love to see some standardization of nursing education, part of what makes this such a rich profession is the fact that there are so many ways to get in. I love that I have classmates from so many different backgrounds; if I have a question about anything not related to nursing, there is almost certainly someone in my class who is an expert in that field. I love that.

The second point I like to make, and I make this explicitly clear, is that I don’t believe that BSN nurses are “better nurses” in any way shape or form. Do I need to repeat that? I don’t believe that BSN nurses are “better nurses” in any way shape or form. Are they different nurses? Yes. Probably in the fact that as a stopping point, ADN and BSN nurses have different career goals.

WHICH IS FINE!

Ok, I’m done rationalizing myself. From this point on, no one is allowed to take offense to anything I say.

I have a blogger friend who is in the midst of her own ADN versus BSN crisis right now. And she kinda got me thinking. I imagine that since the beginning of BSN programs and then the addition of Accelerated BSN programs, this is a tipping point that every possible-nursing-student must hit, especially the non-traditional ones. I know I did, and I spent months chewing on it. I asked every person that might care, bounced ideas off my husband until we were both blue in the face, created millions of detailed and intricate spreadsheets, analyzed the cost to benefit ratio of every possible choice.

In the end, I did what was right for me and my family. And I’m pretty sure that’s what it all boils down to.

I completed my prerequisites, put myself on numerous waiting lists, and at the same time, applied for a BSN program. Ultimately, it was the BSN program that was the long shot, given their percentage of accepted students. I had decided that if I didn’t get into the BSN program, I would get my ADN and immediately do the ADN to BSN bridge program, which would lead me into a Master’s degree one or two years down the road. If I did get into the BSN program, given the fact that it was considerably more costly, I would wait a few extra years to get my Master’s degree.

For me, a Master’s degree has always been in the cards. Now, I couldn’t tell you when, or where, or what for, but it’s in my future. If you have absolutely no desire whatsoever to get a Master’s degree, then the argument could easily be made that an ADN is the better route for you. And as with my plan, even if you change your mind, an ADN is not a bad route to go.

I got lucky and got into an accelerated BSN program. I hear a lot of questions about those programs, as well. What can I say about the accelerated program? It’s perfect for me. As a rule, I tend to be incredibly fast paced. Some may call me hyperactive. I learn quickly. I bore quickly. I’ve given my life over to the nursing program. I have no children. These are all reasons why an accelerated program works well for me. (Although I have classmates with children; the two aren’t necessarily mutually exclusive but I do have it easier then them.) I’ve had numerous non-accelerated friends tell me they would never want to be in an accelerated program and they think we’re all insane. Perfectly fine. Now that I’m over half-way done, I would never want to be in a traditional program. So there!

I guess what I’m saying with all this is that there is no right or wrong when it comes to nursing programs. Everything is dependant on your goals, your style, your personality, and your ability to turn your entire life over to nursing school. Can you do it? Do you want to do it? And most importantly, what do you want to do after you are a nurse? Is bedside nursing your ultimate goal or do you want to teach? Each of these questions and points are important to consider when deciding your own, individualized path to nursing.