Wednesday, June 30, 2010

Pause

Finals are over. I've got one more day of lectures, and then a four-day holiday weekend. Sometime soon I will have a post that talks about something other than how busy I am.

Wednesday, June 23, 2010

Test Season Continues

My most recent post mentioned that midterms had just finished. Today, about a week later, I'm halfway done with finals.

The speed here is set a few notches above "ludicrous."

This week contains six tests, most of them disproportionately crazy-making. Foremost among those was yesterday's drug calculation exam. This is one which you can take up to three times, because you absolutely must pass it to continue in the program, and the only passing grade is 100%. Seriously! Any misplaced decimal or fat-fingered calculator button, and you've got strike one. Some of the math phobics in the class have been freaking out over it since orientation.

Not helping those folks was the fact that our medical math textbook, in my professional opinion, sucks ass. This book is junk. It's crap. It's beyond useless. Despite attempting to teach math at the junior high school level, it somehow manages to be incomprehensible to college graduates. I don't think anybody in the program learned a single thing from its illogical explanations. I have a degree in mathematics and I don't even understand what it's trying to say half the time. I feel stupider every time I crack the cover. In the presence of this book, Math Itself shakes its head and looks disappointed.

(I have rather strong feelings on this topic.)

For my classmates who were nervous about math to begin with, inability to follow the textbook threatened to push them into full-on panic. I did a lot of informal tutoring in med calc this week, and I'm not unhappy to have spent the time, because even the most math-hating person in the room aced the test on the second try.

Anyway, that was one of two exams on the first day of finals. The other one that day was the Communications practicum. It involved a lot of longhand writing in unnecessarily cramped little spaces. That sucker took almost two hours, had no such thing as a right or wrong answer, and I don't want to talk any more about it.

Today we had an exam plus a practicum, covering procedural details. Want to know what gauge and length of needle to use for adult ventrogluteal intramuscular injection? Or how many drops per minute you should set on microdrip tubing to run 125 ml in an hour? Or the proper sterile technique for suctioning a tracheostomy? Apparently those facts and others have seeped into my skull over the past few weeks, because they bubbled back up when summoned.

The real killer exam will be Pharmacology, but that's not until Friday. Tomorrow will be devoted to studying for that. Tonight I shall take a few hours off to rest my overfilled brain.

No grades are posted yet. Every secretary in the building was away at mandatory software training, leaving nobody to run the Scantron machine or log grades into the computer. I profess surprise that the school itself did not audibly grind to a halt.

Monday, June 14, 2010

One Down, Many To Go

Well. That wasn't so bad after all.

Our first set of midterms is done. On average they were about as difficult than I had expected, which means far less difficult than I had feared. In retrospect I think all that anxiety was a good thing, because it motivated me to spend a whole lot more time studying than I otherwise would have. That extra effort definitely raised my numbers.

My lowest score was an 86 in Pharmacology. That just barely makes a B, a very respectable grade which I will by no means complain about. However, I will say that right after finishing that exam, I thought I'd done a lot better. I had spent a lot of time making flash cards and re-reading my notes, and I really had a good grasp on the material. What tripped me up was grammar. A lot of the questions could seemingly be read in more than one way, and on every question where I had to guess, I picked wrong. (On further examination, the intended meanings are clear enough, and I couldn't honestly argue for more points.)

The grades on my other exams are higher. As of today I'm feeling very good about my prospects in the academic side of things.

Skills tests and the practicums have yet to start, but we'll burn that bridge when we get to it.

Monday, June 7, 2010

No time for blog, Dr. Jones!

Oh. My. Crap.
How is it time for midterms already?

The phrase "accelerated nursing program" colossally understates the amount of acceleration going on around here. We have had just two weeks of classes-- minus time for orientation, the hello breakfast, and Memorial Day off-- and that already puts us halfway through the first semester. I thought I knew what I was getting myself into, but the reality of it is doing weird things to my brain.

For instance, I have a list of 21 topics I need to know for my Health Assessment exam on Tuesday. It doesn't sound like a lot, but that's just the high-level topics, and each covers a large part of a textbook chapter. One of those topics is "General Survey," and that is made up of four sections: physical appearance, body structure, mobility, and behavior. The "Physical Appearance" section then subdivides into five things: age, gender development, facial features, skin tone, and level of consciousness. Each of those has a list of things to look for and comparisons to make.

I tried to expand the whole topic tree in the form of flashcards, but I didn't have enough cards to make it work.

(Index cards come in packs of a hundred and fifty, BTW.)

And that's just one of three exams I have this week! It would have been four, but the holiday last week pushed our Monday class out of synch with the others. I'm definitely not going to complain about that.

I expect I'll feel a whole lot more confident after I sit the first exam tomorrow. A lot of my uncertainty is just because I haven't seen what kind of test these professors write. I know that I'm great at memorizing, but who knows how good I am at thinking like a nurse?

Wednesday, June 2, 2010

HIPAA

Today, amid the usual eight-hour day full of classes, we got the legally mandated lecture on HIPAA (the Health Insurance Portability and Accountability Act of 1996).

I'm not even kidding about the "legally mandated" bit. Before we're allowed to go work in a hospital for clinical experience, we are required to get a certain amount of training about HIPAA. Every student in the place had to sign an attendance sheet to show that we were there. Anybody who was absent, or somehow failed to sign it, will have to sit through the same lecture again some other day.

They explained some basic history of the law, and its significance-- biggest health care legislation in the last 38 years, blah blah blah-- but what they're really interested in is the privacy provisions. The hospitals want to be absolutely sure we know that personal information is not a toy. I can understand their reasoning, because if any of us student nurses screws up, the student is not the only one who's gonna get sued.

A lot of the privacy concerns are blindingly obvious: Don't leave charts lying around in the open. Don't tell your neighbor about the procedure you did on his pool guy. Don't take a picture of a patient's unusual wound or condition and post it on Facebook, no matter how awesome or gruesome or embarrassing it looks. (Well, maybe that last one isn't quite as obvious as I thought.)

Some of the stuff is a little more interesting, because even though it may be obvious to me, it may be novel information to anyone without a security or IT background: Keep permanent records safe permanently. Destroy temporary records when they expire. Don't share your computer password. Don't copy confidential information onto your personal laptop.

Then there's the tricky bit. A health care worker may not access the records of anyone-- even in the department where they work-- unless that worker has a need to know that information for their job. This means if a famous celebrity comes into your hospital, and is being treated on your ward, but you personally are not caring for them, you must not access their records. Every access to electronic records is logged. People really do get fired for "just looking," and recently, a surgeon in California even got sent to prison for reading stuff he wasn't supposed to.

There seems to a little bit of a gray area where we student nurses are concerned, because teaching is an expected operational function of the hospital. A student can be given access to case information that is interesting for educational reasons, like a rare disease or a particularly unusual presentation. But there has to be a reasonable teaching purpose behind sharing the information, and "curiousity" does not qualify.

Because I don't want to be sued or go to prison, this would be a good place to note that if I ever post here about patients, everything will be disidentified and anonymized. Any identifying details (like name) will be removed. Anything that could suggest identity (like age and sex) will be randomized by flipping coins and rolling dice. If you ever think you recognize someone in a story here, I assure you that you will be entirely incorrect.