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Archive for March, 2011


This week I get a site visit from one of the university instructors. The site visit is THE thing I am nervous about…very nervous.

Generally, I can go into the exam room now and get the patient’s history and complaint, do a physical exam to find the actual problems and report to my preceptor what I found, what I think the diagnosis is, and formulate a treatment plan. I can do all this and look reasonably competent and confident.

However, I have this thing about being watched and scrutinized while performing, my version of stage fright. This may seem strange after teaching nursing to LPN students, standing up in front of the class and lecturing and such. But being watched by someone who is scrutinizing my every move and checking items off a fifty point checklist…well, THAT is my bugaboo. The problem is, that when I am nervous, my mouth goes into overdrive, I start to talk really fast, I get tense and jittery.

Did you ever hear the term “blithering idiot”? That about describes it.

My family and friends, my preceptor, everybody says “you will do fine, you know what you are doing, don’t worry about it.” But it is not so easy. The words I gave my students when they went to clinicals for the first time are back to haunt me again. I told them to “pretend you are confident, play the part of a great nurse, the patient will never  know, and you will feel and act more confident”. Okay, I will pretend she isn’t there watching, I will pretend I am super confident. I will not degenerate into a blithering idiot. I will review the checklist a million times so I don’t miss anything.

I will try to forget that if I don’t pass this site visit and evaluation, I fail the class. O crap. I am confident, I am a great nurse practitioner, she isn’t there watching me, I will do fine.

Thursday is the day. Friday I will report back whether this blog continues or not.

I will be confident, I will be confident, I will do fine. I will do fine.

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Before I write my post, I have to express my sadness at the horrors that the people of Japan are facing. My prayers go out to them. No other words would be adequate…

Okay, my post about student nutrition. Every day I dutifully educate and counsel patients on diet and exercise to reduce weight, cholesterol levels and blood sugar. I feel like such a hypocrite.

 When the long clinical day is over, and I flop down on the sofa, the last thing I feel like doing is planning and cooking a nutritious meal, or riding my bicycle. I still have to spend at least an hour or so inputting the patient encounters into my log on the computer, respond to the weekly case study and look up and review some of the things I saw that day. By the time that is done, the brain and body are catatonic. My husband is not in any better shape. While he was unemployed for quite a long while, he was an angel, taking over the cooking and shopping. Now that he has a job, he is exhausted when he gets home. The job he has is very physical, and being in his late 50’s, it is tough on him.

Bottom line, at dinner time, we look at each other blankly, wishing that a cook would miraculously appear to feed us. So, in general this is the nursing student dinner hit parade:

  • Pizza: the guy at the local pizza shop recognizes Randy’s voice now and can take our order before we even say what we want. It is always the same, thinking up new and exciting pizza combinations is beyond our mental capacities. I suspect our house is programmed into the delivery guy’s GPS as a favorite.
  • Chinese food: again, the guy recognizes us, and also knows our order by heart
  • Omelet: It takes exactly 7.5 minutes to make an omelet with cheese and toast
  • Grilled cheese and soup: This takes about 13 minutes, so we need to be more ambitious for this one.
  • Healthy Choice or Kashi box dinners: These come in when we are feeling guilty about too much crap food and the clothes aren’t fitting so well.  One or two nights of this has us back on the phone ordering pizza.
  • Fast food: I can say we are proud of ourselves in that we almost never eat fast food, partly because it is so disgustingly bad for us and partly because we have to drive pretty far to get it.
  • Publix hoagie: If I have even a tiny bit of energy on the way home, I will sometimes stop and pick up a large Italian hoagie which we share.
  • Rotisserie chicken and macaroni and cheese: otherwise known as death by cholesterol and salt. Now this is not the boxed macaroni and cheese, that is WAY too much trouble, I mean the dish of nice, creamy frozen mac that you heat up in the oven. We can make this combo last a couple of days. If we are really ambitious, there will be a salad with this.

Here is hoping that we survive the nutritional deficits until I graduate. Then, I will have the time and energy to enjoy cooking again. My cookbooks and cooking magazines will get dusted off, and the kitchen will smell of baking and spices again. I will have to see if I can locate my bicycle under all the stuff in the garage.

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So, there I was last Sunday evening, watching TV and looking forward to my first full week of clinicals at my new clinical site, my own doctor’s private family practice. I felt a little tired, and had a slight sore throat. Nothing out of the ordinary, really.

Two hours later, everything was different. I woke up sweating, with a very sore throat, and nose all congested. I started coughing. By the morning, my temperature was 101, I had body aches, chills, terrible headache, was coughing very hard, and just generally miserable. Okay, I thought, I  have a nasty cold. Fluids, rest, vitamin C and cough syrup ought to do me. I’ll be right as rain in  a day or two. The next morning I thought I was doing good, temperature down to 99, things on the mend. Not so fast…

The train hit me early afternoon, temp shot up to 103, I felt awful, coughing my lungs out. My throat hurt so bad from all the coughing, it felt like I was tearing it out. Every part of me ached, including my head. Migraines are nothing compared to this, what with coughing like that. I thought my head was going to explode. Quick call to the doctor’s office, Tamiflu called in to the pharmacy. Holy cow that stuff is expensive! Okay, time to realize, this is not going to be over so quick. The crappiest part of all this is, I had my flu shot this year, and this still happened.

What followed was days of hacking, continuous coughing, to the point of throwing up, no appetite, no energy, just totally miserable. I lay in bed with a cold washcloth clamped to my head, tissues, a trash bag, thermometer, cough syrup and stuff to drink all at hand. The temp came down to 100 and stayed that way for two days, then dropped to 99 for two more. Finally, this morning: a normal temp. I feel completely washed out, and I am SO TIRED of coughing. At least the throat doesn’t hurt anymore, but the term “stress incontinence” now has a real personal meaning.  Of course, being a nurse, I listened to my own lungs (it’s hard to do that, I tell you, the tubing is not quite long enough on the stethoscope to do it easily) to make sure I wasn’t getting crackles or rhonchi.

Today, is the first day with a normal temp, I feel much better, just very tired, and I still haven’t gotten rid of the cough. My doctor, it turns out also went home on Tamiflu. I hope we are both recovered enough Monday that we can get back to clinicals and normalcy.

Having the flu sucks, it is like losing a week of your life.

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