It’s Official

Big news…I’m self-hosted! WOOHOO!!!!

Head on over to the new bright and shiny The Makings of a Nurse for more adventures. 🙂

Thank you for your continued support!

P.S. Don’t forget to change your reader feeds…all new posts will only be visible on the new site.

On the Horizon

Exciting things are happening here at The Makings of a Nurse!

Stay tuned in the VERY near future for some big changes. 🙂

Say My Name

The self-hosting journey is about to begin, folks!

And in honor of the changes coming ’round the bend, I’m considering another big move: a name change for the blog.

On one hand, I’m no longer being “made into” a nurse because I’m licensed and practicing. On the other, I’ll never stop being transformed by my profession. So the “makings of a nurse” will still apply.

But if I’m gonna make a change, now is as good a time as any.

Help me decide by participating in the poll below. Stay tuned for some exciting transitions and thanks in advance for your feedback!

Death With Dignity

The other night I forced myself to sit down and watch a documentary I had recorded.

How to Die in Oregon.

It’s the story about people who have elected to use the “Death With Dignity” Act in Oregon, which allows them to take a prescription to end their life when they have been diagnosed with a terminal/life-limiting illness. It’s also the story of the movement to successfully pass the same law in the state of Washington. It’s about the volunteers from Compassion and Choices, who offer support and education about options at the end of life.

I knew it would move me for obvious reasons. And even though I had anticipated the broadcast on HBO since early this spring, I could only now bring myself to bear witness.

Not because I have a problem with the law. In fact, it’s just the opposite. I think it is empowering and beautiful to have the choice to peacefully slip away before the pain and suffering and delirium set in. I think rather than close doors, this option actually creates opportunities to choose life.

I know it sounds like a contradiction that choosing to end your life means choosing life. But if you’re not afraid of the suffering, if you know the end result will be quietly falling asleep, surrounded by your loved ones, then I think it frees you to live the life you have more fully. Rather than fearing what’s around the corner, you can celebrate relationships, plan trips, cross things off your bucket list, get your affairs in order…

I sometimes wonder whether my father would have chosen this option if he had it. I honestly don’t know. And there’s no way we would have pressured or pushed the issue. But he would have had the freedom to go to a pharmacy and tuck the pills away somewhere. He would have had the freedom to say “Enough is enough” and because he would have made the choice, he would have had the time and space to say goodbye on his own terms. Rather than lie in a hospital bed in my parents’ bedroom, delirious from debilitating pain and fear, not ready to let go because none of us saw it coming. Even though we all knew it would come someday.

The reason it was so hard to sit down and watch was because it made the abstract concrete again. I’ve spent a lot of time and energy advocating for improved palliative and hospice care since I began nursing school. I’ve done it in honor of my own family. But it’s been advocacy and education at a more cerebral level, supported by the wisdom of personal experience. Watching the film, I relived the experience in a raw, guttural, physical space.

It wasn’t about philosophy and politics anymore. It was about people. It was about my Dad.

Where do you stand on the idea of a Death with Dignity Act in your state? Do you think it’s helpful or harmful to people with terminal illness? *I know this issue can get emotional, so please refrain from personal or political attacks…just speak from your heart*

Another Personal Plea

Last year I asked for tips to cope with my migraines. Thank you for your personal and professional advice. You’ve seen me through quite a saga.

I’m back again seeking your wisdom.

My new neurologist is playing with my medications (at my request). Although it’s clear to both of us that I still need to take a daily prophylactic med, anticonvulsants will not be an option when it comes time to make babies. Which will hopefully come soon after getting hitched (did I mention that’s in less than 90 days? SO EXCITED!).

So we decided better to monkey with things now than when I’m attempting to get pregnant (or already pregnant and still getting headaches with no relief).

Doc switched me from Zonegran, an antiepileptic, to Inderal, a beta-blocker. I’d heard that beta-blockers can be extremely effective in preventing migraines. And in the words of my neurologist, I’m apparently “tightly wound,” so it wouldn’t hurt taking something that helps me tone it down a notch or two. Yes, apparently even my brand new doctor can see that I need to take a chill pill. Literally. Sheesh.

I’m two weeks in and unfortunately all this crap makes me want to do is sleep.

Or faint. I attempted Zumba the other night and almost passed out after 20 minutes. I could feel my body screaming for oxygen, but my heart rate wouldn’t rise to meet the demand, and therefore my cardiac output was insufficient (Yay pathophysiology?). It wasn’t pretty.

So anyone else out there taking Inderal for migraines (or anything else)? Does this blasted exercise intolerance wane? PLEASE tell me your body adjusts!

Reality Check

I finally received my security clearance from the VA. Don’t get me started on how many hours I spent playing with my Twitter feed in that damned HR waiting room.

I celebrated the momentous occasion with a three-day migraine, so last night ended up being my first clinical shift.

All I can say is, now I remember why I left the hospital. 😉 (And I’m not even at a hospital – I’m at a long-term care/skilled nursing/acute rehab/hospice and palliative care center. But it’s acute enough for me!)

Since I started working in community health, I have always wondered if I left inpatient care too soon, if I didn’t give it a fair chance. After 8 hours back in the mix, I feel confident that I made the right move for myself.

It wasn’t the fear of not having the skills. I did work in a progressive care unit and was about to start flying solo when I left. I can take blood sugars and prime IV tubing, thankyouverymuch.

It wasn’t the patients. I really enjoyed bantering with the vets.

It wasn’t the staff. They were incredible.

It was that hectic, wigged out, “this shift isn’t long enough” feeling that plagued me the entire time. It was always checking the clock, checking my clinical brain, checking my watch, wondering if I was forgetting something and what I was missing. I hate that feeling. Anxiety is already my middle name. It may make me a more vigilant nurse, but it sure isn’t good for my health.

There are moments when I do worry if I have painted myself into a professional corner, so to speak. If I ever did get the inkling to return to acute care nursing, would I be able to catch up? Am I limiting myself to community health jobs only? It’s such a different world outside the hospital walls.

But if there is anything I’ll take away from this clinical experience, it’s that I left the world inside the walls for a very legitimate reason.

No regrets.

Regrouping

It’s amazing what genuine validation can do for the human psyche.

I entered my meeting with the Dean totally deflated and ready to leave the school entirely. I left still frustrated with my situation but more hopeful that I was being heard.

I guess there’s a reason she’s the Dean. 😉

I’m also impressed that the school is doing its own Root Cause Analysis on this delay. Which means they are going to pick the process apart piece-by-piece and figure out what may have contributed. Find the “root cause,” so to speak. Their willingness to turn inward impressed me.

Plus she pleaded with me not to leave. I can’t deny that it felt good to feel wanted. The cynical side of me says of course they want me – graduate tuition is $$$. But I have to believe that this woman had more honest intentions.

We talked at length about my cohort’s concerns. About feeling unheard. About getting to the collective point where we just want to graduate and walk away. About feeling coerced into staying because we needed a nursing degree. She talked about believing that the program needed a serious look and possibly an overhaul. She gave me context about why decisions had been made the way they had.

She communicated. And she listened.

So I’ll put one foot in front of the other.

I still don’t know if it’s mathematically possible for me to finish every one of my hours. But after tonight, I believe that that the people in charge know the situation and are pushing for flexibility. So I feel that I can move forward.

And hopefully still walk across that stage in May.

Hopefully.

Full Circle Indeed

The clinical semester that wasn’t continues to be a huge pain in my rear. We are now in week 8 of 12 for the term, with no sign of my badge. The newest revelation is that we are missing some background check form that we have to fill out on-site and takes a million and a half years to complete. So I’ll be spending my day off Friday doing that. *Supposedly* I’m being told I can retrieve my badge and access codes the same day, but I’ll believe that when I see it.

Regardless, it is mathematically impossible for me to complete this semester’s required hours (and probably next semester’s) without absolutely killing myself. I’m being told one option is to use our three weeks off in August to make up some of the time. So while my classmates have much needed time away from school, we are expected to scramble and give up, oh I don’t know, a much needed weekend out-of-town, or scheduled engagement pictures, or catching up on wedding planning because someone else royally screwed up.  Go ahead and call me a brat, but no thank you. I love that they pay lip service to “self care” until it comes down to the wire.

I’m beyond frustrated with our lead instructor, who continues to pass the blame onto the VA. The hospital may have messed up in their own communication process, but is it not the school’s responsibility to follow up and make sure their student’s placements are a-okay? Preferably before the semester begins? Call me crazy, but I thought that was part of your job description.

So where does that leave me?

Meeting with the Dean tomorrow, that’s where. I have some serious concerns about the program as a whole that go beyond my immediate issues. But you can bet your sweet bottom that she’ll be hearing about my issues too.

I did discover that to sit for the CNL certification exam we only need to do 400 hours including a 300-hour immersion. The school requires 500 hours for some twisted, perverted reason. So I’m thinking of asking for some kind of hours exception, given the circumstances. If it’s all the same to the AACN, I don’t see why the school can’t work with us.

But if that’s a no go, there is one other alternative that chaps my hide but I am seriously considering…

Asking for a leave of absence because I will go insane if I have to cram in almost 200 hours this fall. Then starting this final year over next summer…maybe. But in the meantime, putting my foot down and demanding they make it possible for me to get my BSN so that I have a degree to back up my RN license (which has to be renewed in 2012).

No more nice Nurse Teeny.

Clinical Cluster

This summer semester has been a bit of a mess. (Understatement of the year…)

Where to start?

We have three terms to go ’til graduation (including this one). Which means in May it was time to start working on our required clinical hours for certification as Clinical Nurse Leaders (CNLs). We need 500 hours to sit for the exam after we graduate. So they divided the terms as follows:

• Summer 2011: Needs assessment of site, initial formulation of clinical problem (100 Hours)
• Fall 2011: Continue designing intervention, conduct patient and staff education (100 Hours)
• Spring 2012: Implement intervention to improve clinical outcomes, evaluate program (300 Hours)

We were emailed in January with questions about our preferences for sites/types of placements. I asked for oncology, of any type. Adult, kiddos, inpatient, outpatient, I didn’t care.

Then we waited.

And waited.

In late April I finally got an email from our school’s clinical administrative assistant that I’d be at the VA and would need to fill out all kinds of crazy paperwork. Which I did the next day and returned via email.

A week later I received word from my professor that I’d be at one of the VA’s long-term care settings (known as a Community Living Center). They include hospice units, so she thought I would be thrilled. Wasn’t my first choice, but that’s the breaks. I was excited to work with hospice folks.

Since then it’s been a nightmare. Not because I’ve hated my placement. Not because my preceptor is horrific. Neither of those are true.

It’s because I haven’t actually been allowed to set foot on my site (except for my initial orientation and occasional staff meetings) because I still don’t have my freaking VA security clearance. It’s July. I’m supposed to have 100 hours by August 2.

‘Ain’t gonna happen.

I’ve been told that since this was not my fault or the school’s fault (don’t really believe that second part), I can take an “Incomplete” and finish up my hours in the fall. But most of our assignments are tied to our clinical site, so I’ve literally had to make up “fantasy” scenarios, knowing full well I will have to redo all of these processes when I actually start working at my site.

Not to mention this that means cramming almost 200 hours into the fall semester, and 500 hours total into two semesters. I don’t see how that can happen either with my full-time job. And I’m not willing to cut down on my work hours either. I need to live, for God’s sake (and I REALLY need my benefits).

So here I am, less than a year from graduating with my Master’s Degree and I’m not sure it’s physically possible to do so, through no fault of my own.

What’s a nurse to do?

Speak Your Mind

The folks over at BestNursingDegree.com want to hear from you! They are in the midst of developing additional resources for nursing students and new grad nurses and would love to get your feedback on two important issues:

Expectations versus Realities as a New Nurse

NCLEX Study Tips

Click on the links above and let them know what you think!

And if you are a second-degree nursing student or nurse…

I am working on an article for for BestNursingDegree.com about the particular experiences and challenges of going BACK to school to become a nurse. If you are interested in being interviewed, please contact me at nurseteeny@gmail.com for more information! 🙂