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I passed my final exam…..only the presentation of my project is left.

I suppose I will have to change the blog title soon to “Trials and Tribulations of a New NP”. I have found a position with a group of GI physicians, this ought to be interesting! It is not easy to find a position when you are a new grad, I was lucky to get more than one offer, of which this one worked out the best.

The cool part is, I get to hang out in the cushy doctor’s lounge in the hospital between patients. ūüôā If I have time to hang out that is… Will keep you all posted.

 

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Final exam


I am starting on a three-day cram session for my final exam on Thursday. That will be the end of last practicum course. Wow, is it almost over?

Project to be presented to class next Thursday, and that is it. Done.

I can’t believe it, I will have a life again…

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Wow, I can’t believe it. I posted my clinical hours fron the last 2 weeks, and I get a response from my instructor:

You are officially done.

Really? Already? Have I really put in over 660 hours of clinical time? I am conflicted about this. Part of me says, “You don’t know shit” and another part of me says “Wow, cool, I have learned a lot. ”

I think I will stick with the second part, I did learn a lot.

It’s funny, when I¬† just looked back at what I wrote, the negative feeling was in the third person, and the positive in first. Goes to show that I really do believe in myself and a little voice by my ear is telling me the bad stuff. My heart knows the amazing amount of knowledge I have gained, and experience.

There must be a point in this observation. Don’t listen to that little voice in your ear, listen to the one inside.

¬†One interesting thing, I got to meet a real live alligator wrestler on my last day, he¬†had a bad shoulder. Why am I not surprised? He did tell us that¬†alligators were easier to wrestle when they weren’t hungry…

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A few days ago a patient came in¬†upset about her arm after being in the hospital for a couple of days. She is a lovely older woman I had seen a couple of times before, so when the nurse told me the patient’s arm was swollen, and “fibers” were coming out of the area that the IV had been, I was worried. I tapped on the door and went into the exam room. She was sitting in the chair with an anxious look on her face, holding her left arm out stiffly.

When I looked at the arm, I didn’t see any swelling or bruising, no redness, nothing. She pointed to her forearm and said “Look, see this dark area, there are fibers coming out of it! What is wrong, what could do that?” She was visibly upset. I looked where she was pointing and saw the distinctive square outline of tape marked in leftover adhesive. Little bits of thread and lint were stuck on it. ….Oh.

I explained to her what she was seeing. “Do you mean that all that is, is¬†DIRT? I am so embarrassed, my husband will laugh at me!” After cleaning off the adhesive with an alcohol prep pad, I suggested that she could tell her husband she had a bad case of adhesodermatitis, but we were able to treat it successfully. She liked that and left with a smile.

So, the first two parts of the project are done: the matrix and the evaluative summary (review of literature). The entire floor of my study room and all available horizontal surfaces are covered¬†in articles and studies duly printed on my printer after a “literature search” on all of those lovely databases. Most were rejected, 20 remained and were loaded¬†into the¬†matrix. Did any of you see that movie? I felt like one of those people in the little pods by the time I was done. My entire world had shrunk to the size of my laptop screen, the actual reality world disappeared. My husband forgot what I looked like and my dogs gave up on presenting enticing toys for me to play with.

The end result of all that study? I found out that the available research about diabetic foot ulcers and preventive education basically sucks. I barely managed to get enough info to do the project. Hope I still get a decent grade.

Actually,¬† I lied about the dogs not giving me toys. One of them thought I might be tempted with a mouse. Here I am, in crisp white lab-coat, ready to go out the door to clinical and…..

Yikes! But he was sooooo proud of himself!

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A classmate who is a term ahead of me, (well actually she has just graduated and passed her certification exam, too) told me that when she first opened the instructions for the scholarly project, she almost threw up. When I first read the instructions, I felt the same way. It is like a thesis in a nutshell. What doctorate students do in acouple of years, we get to do in 15 weeks. Kinda like reading Harrison’s in 15 weeks (2880 pages)…

Our first assignment was to post our understanding of what the project is:

My understanding of this project is that we are to:
1. Identify and research an issue related to family practice which can improve health care in some way, by changing a protocol or creating an educational tool for patients, as examples.
2. Research this topic through an extensive literature review to determine the latest and best information on this topic, and give reasons why the topic is important and appropriate. We will describe in detail how and where we found the information, and analyze the studies using a research matrix to organize and make sense of the findings, and write a report of the research findings.
3. Use the information to develop an intervention such as a protocol change, an educational tool or presentation or evaluation tool, etc., using a theoretical framework appropriate to the topic. We will find established or create new tools for measuring the outcomes of the intervention plan.
4. Implement this plan and evaluate its effectiveness or impact using the measurement tools.
5. Make a comprehensive presentation of the topic by writing a scholarly paper.
6. Present the entire project to the class via a powerpoint presentation
7. Provide feedback to our classmates throughout.

Oookaaaaay…..I¬†know I can, I¬†know I can…just call me Thomas the train.

Well, they say you can eat an elephant if you do it one bite at a time…

So the first bite is deciding on the topic after voluminous research including only primary sources. Primary sources include clinical trials, case controlled studies, etc. Lots of digging through databases including Med Line and CINAHL, reading about correlation, significancy, variants, samples and cohorts, analysis with various esoteric formulae. A little light reading,  hahaha.  All those mad scientists out there love to write up their research in a way to make you crazy yourself trying to figure it all out.

Okay, one bite at a time, what will my project be about? Let’s try diabetic feet.

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Well, my last term starts Monday. I just got back from a week of vacation in upstate South Carolina, again. We do love it there. I managed to wash and dry my cell phone (we thought the dryer was clumping kind of loud) and so no-one could call me. That actually was kind of nice. We took walks in the woods with the dogs, explored the area and discovered some new things. Generally relaxed and lollygagged (also gained a few pounds, oops). I took several school books with good intentions of doing some reading. Yea, right.

Now, I am home again, faced with the pile of books I meant to do some reading and studying in and the new term looms. I was good today, read a few chapters in my orthopedic book. Orthopedics is one of my weaker areas and I need to bone up a bit. It seems strange that there is only one more term, 15 more weeks. I am so not ready to go out there and BE a nurse practitioner. Emotionally scary, that. I suppose that is how all new grads feel when they go out there, so I will try not to perseverate about it.

My big concern this time is the SCHOLARLY PROJECT…..the dreaded thesis of yore. A classmate who is a term ahead of me stated she almost threw up when she read the syllabus and expectations of the scholarly project. Okay,¬†I suppose that is good to know ahead of time. She did say to really work your ass off the first week to fill in the “matrix” and the rest would flow.¬† Now if I could just think of a good subject, which is a little hard to do if you don’t know the expectations. I have fiddled with the ideas of diabetic foot care, the shingles vaccine, medication compliance issues¬†and fall prevention in the elderly.¬†

Last term I was still excited about getting the books and prepping my work space. This term is different, motivation seems to lower. The difference must be pretty much sheer exhaustion, mental and physical, and also the realization that, once this is done, I need to go out there and apply for jobs. Yuk, I hate applying for jobs. In the past, every time I thought I was getting a good one and the people seemed nice and all that, the job turned into a disease. The employer owned you for a salary, and always took advantage. I am too damn old for those games now. I hope that I can find a nice quiet little corner to do my thing, working with nice people who appreciate me. Is that too much to ask? Hopefully not. I work hard, I am honest, I care about how and what I do. Sending up prayers, God, that the right place will come up for me. Heaven knows I have worked hard enough to get to where I am educationally.

So, here we are, sitting at the desk. It is dusty, there are coffee rings on the surface. The books are stacked a little haphazardly. The pencils are not sharp. Piles of old clinical log sheets and papers take up half the space. The laptop is new, the old one fell off the sofa and died a spectacular death. I never saw such weird patterns on the display before…at least that was after I took my final. Do I feel like making it all pretty and tidy? Not this time. The piles of papers will have to go on the floor to make room for the new ones. I will push enough stuff aside to make space for the new stuff, and I will continue to plug away at all of this, including the “matrix”, until is done. 15 more weeks…

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I am assuming that uconn stands for University of Connecticut, also assuming it is the medical school. I have recently received several really nasty comments on my postings from email addresses with uconn.edu as the place they came from. I am choosing not to allow the comments as they contain words like “cowards” “phonies” and “losers” and other such names.

I am hoping that this is not the average med student’s mentality. God help us if it is…I would think the real loser is someone who stoops to petty name calling when speaking to people who are trying to do some good in this world by caring for and about others.

I would have hoped someone who is in medical school would be above kindergarten name calling. Unbefrickenlievable!

 

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