Nursing: Killing Perfectly Healthy People Since God-Knows-When

I took one of two pharmacology exams I have to pass in order to be a nurse today. It was open book (yay!) and written by my least favorite instructor. Below are two actual questions from the two exams. Don't worry, I know not everyone that reads this is a nurse, so I'll explain.

1. What IV solution would the nurse most question giving to a woman on potassium-sparing diuretics?

a) Normal Saline
b) D5W
c) NS with 40 meq K
d) water

Ok, here's the breakdown. Normal saline is just what it sounds like. Normal. A-OK. D5W just has some extra sugars in it. As long as she's not diabetic it's also par for the course. I would be seriously cautious giving normal saline with added potassium (K) as the meds she's on makes your body hold onto potassium like an OCD hermit holds onto tupperware. Apparently that was the right answer. Which at first makes sense. Giving extra potassium makes your body do fun things like have major seizures. Not cool. The only thing that makes this 100% wrong is that you also have the option to choose d) water. Giving extra potassium= possible bad things. Giving WATER through an IV line makes this happen:

That's right. Injecting water into the blood stream makes your red blood cells swell up and BURST. Your blood sees the water and guzzles it, frat party style. And then dies.

So, of course, when the world's smartest teacher (from here on in referred to as TWST) announced that the answer was C I put up my hand and asked why it wasn't D. Her reply?

" We wouldn't use tap water"

Oh good. We may make their red blood cells explode, but at least we won't give them sepsis. I feel better.

That was on the first exam. The next gem is from today's.

2. A mother asks an RN who gave her child a vaccination "How do I make her feel better?". The nurse should answer
a) "Don't be so weak, she'll be fine."
b) "Put a cold pack on the injection site"
c) "Give her baby aspirin"
d) "Put a warm compress on the injection site."

Ok, this one isn't QUITE as stupid. But still. I'm thinking that in response to "How do I make her feel better the nurse should, perhaps, answer "What is the matter". Because C (the official correct response) may make a slightly swollen injection site feel better, but it's not going to do a whole heck of a lot for anaphylactic shock......sorta a majorly scary adverse reaction to being vaccinated. When I asked TWST what I was expected to make of this question I was told

"It's right there in the question. She's got a swollen injection site."

I copied the question word for word. Does anyone else see any mention of a swollen injection site in there? I didn't think so.

You know what makes me extra lucky? I, and I alone, have TWST for a practicum instructor. Think of all the individual attention. I can't wait.

Dreams, Goals and Other Imaginary Beasts

I went to my friend A.M.'s wedding this weekend. Her, me and B all lived together in 3rd year. We did things like taping signs to B's back while shopping in Jysk, making casseroles out of whatever we happened to have in the house, and hosting parties that you had to dress up as a fake superhero, complete with a unique superpower, to attend. I was The Plague, B was Passive Aggressive Girl and AM was Master Debater. Also in attendance were such greats as Corporate America (a supervillan), Crazy Tennis Playing Guy and The Highlighter. AM's car used to break down about once a month and I remember using the fact that her battery constantly died as an excuse to talk to the guy I liked who lived across the parking lot.

B and I wrote a toast to give at the wedding and while doing that spent about an hour sitting around and reminiscing about that year and the rest of our times in nursing school. It all seems so long ago, but really first year was only 2004. Its weird that some things have stuck so much and others have faded out. I only remember parties at "The Party Quad" these days when I am consciously thinking about them. But I still call T Treeesh, and spell it out with 3 E's every time. B and I still involuntarily quote Jimmy Falon whenever we walk past the leather store in the Kamloops mall ("Eeehhhllleather).

What are this reminiscing boiled down to was one thought: just how much we all have changed. How weird is it that someone who taught me all I know about applying smokey eyeshadow and picked me up from work wearing a dress shoes, Pj pants and a towel on her head just got married? It's definitely strange that the girl who's fish tried to die every time you looked at it just bought a house, with spare rooms that I can stay in if I ever pass through town. Sometimes I just don't know what to do with the fact that the world is growing up around me. Every time I turn around another of my friends is getting married. Everyone I know seems to own a house, a dog and a new car. I can list off 5 people that I went to school with that either are pregnant, are trying to get pregnant or have had a kid in the last year.

Sometimes all this change gets a little overwhelming and starts to get me questioning my choices in life up to right now. It seems like everyone else is going the regular "mature adult" route, while I seem to be hacking my own path through the underbrush. Yet I never doubt that what I'm doing is right for me when I'm bouncing along a dusty road in Cambodia in the back of a pick up truck, holding two Cambodian babies and sharing coconut rice out of a bamboo tube with a toothless old lady. Even when I'm upside-down in a river in Nepal and semi-convinced that I'm about to drown I know that each near-death experience is going to be something I will never regret. The only thing that makes me question myself is sitting in a room decorated with tulle and fake ivy, twinkle lights and a cake on a pedestal, surrounded by people that are so happy that someone else in their lives has reached this adult milestone.

I guess it turns out that aspirations are kind of like perfume. If you spend enough time surrounded by someone else's dreams (especially when they are on display as conspicuously as a wedding, kinda like dumping a bottle of perfume over your head) you start to wear it, and for awhile it almost seems right for you. Then you get back out into the open air and realise: I smell like a rose garden. When in my life have I ever wanted to smell like crushed gardenias? The scent of vanilla pods and lilies may seem grownup and classy, but what if I really like smelling like raspberry body mist?

Time to Get a Job

I just finished the "What to Expect in the Big Wide World" class. Here's what I've been told I can look forward to in the first year out of school:

-for the first 4 months after I graduate I will be so concerned with doing things right and making people like me that I won't be able to sleep, I will lose all my friends and any semblance of normal social life and all the experienced nurses will view me as an indecisive suck-up.

-eventually this self-doubt will get tiring and I will begin to pretend I get it, at which point the experienced nurses will start calling me cocky.

-I will have 2 serious crises of confidence: one at 4 months out and one at 8. Each of these will be above and beyond an overall feeling that I will never be a good nurse, that I made the wrong career choice and that everyone is judging me (which they will be).

-I will kill someone, either by a med error, oversight or overwork driven neglect. Apparantely everyone does.

-Everything I have learned up to this point is useless, as the real world is not a textbook.

I'm stoked.

Welcome to Kamloops: Now With 500% More Racism

Public transit is always an interesting thing. You never know who you are going to run into or what manner of drug induced rambling you will get to hear. Usually, I don't mind the bus. It's sometimes a little sad, often a little funny and generally kind of ho-hum. Today that changed.

Today as the bus was about to pull away from the curb at a major transit exchange, one last lady flagged it down. She ran aboard, flashed her pass and began to make her way to the back of the bus. All normal, except that, when she passed an older black man, she paused every so slightly, screwed up her face and spat out "F*cking N*****." Seriously.

I've never seen so many people have to actually pry their jaws off the floor. She said it so loudly I heard it through my headphones. Everyone, including the man it was directed at, reacted with stunned silence. When was the last time you heard that word not in the context of:
a) a rap song
b) a movie portraying racism in the southern states or
c) a movie where producers are trying to show they are "down with the lingo" of inner-cities?
I don't think I ever have. I mean, this is Canada. Sure there is racism here, but people generally go to great lengths to hide it. This hit me the same as reading about the peace protesters clashing with the white supremacists in Calgary....there are really people that think like that?

The worst part is, that's not the part of the story that made my blood boil. Q was obviously mentally unwell (stained parka in May, almost dreadlocked hair, twitchy erratic movements, random tearful outbursts). The worst part is that nothing happened.

The lady said it so loudly that for the driver to not hear he would have had to actually have his fingers in his ears and be going "LALALALALA" at the top of his lungs. But he didn't do anything. When he failed to act on his own a woman sitting behind me, let's call her A, went up, told him what had happened and asked that the woman be removed from the bus. He said that, as he hadn't heard it himself, he couldn't do anything. When the woman told him that the whole front of the bus had heard it at least five of us piped up and agreed. Still, nothing. Even Q, between telling the woman talking to the driver to get some class and shouting something about her pimp, admitted that she had said it. Nothing.

How can this be? The buses all have placards posted with the rules of transit on them. One of them is that people have the right to ride free of harassment. I don't really think that it's open for interpretation, but this driver made it that way. If nothing happens to him then the transit authority is basically telling everyone that all WHITE people have the right to ride free from harassment. I don't understand.

While I was still on the bus Q got off, threw a quick apology to A and the man she had originally insulted. He just sat there, through her hurried "I'm sorry", through people around asking if he was alright, staring at his hands. How do you react to that? This isn't Hickville, Texas. No one is on their guard to have racial slurs hurled at them here.

So that's the majority of the story. I have called the transit authority to complain. So have 6 or 7 others that were on the bus. When the answer to my complaint was "Ya, ya, I've already put a note in the managers box, ok?" I also called the newspaper and told them the whole thing. It's apparantely going to be in the next days paper. I might even be photographed for it. But I'm still feeling confused and thrown off guard. My naivety and belief in human goodness both got a bit of a shake and I think they might need some time to recuperate.

As a finishing note I'd like to throw in a quote I just found on another blog:

"Racism isn't born, folks, it's taught. I have a two-year-old son. You know what he hates? Naps! End of list."- Dennis Leary

Exactly How Wrong is it to Strangle People?

Are we talking burn in hell for all eternity wrongness? Fighting lawyers, politicians and crooked salesman for a tablespoon of cold water? Or merely a stint in purgatory? Or do you thing the wrongness is relative and gauged on a sliding scale, kind of like insulin? The more legitimate your reason, the less the wrongness. Example: going back in time to strangle Hitler before the Holocaust= A-OK. Strangling someone because they sat in your seat at the theatre= eternal damnation.

I need to know the answer to this question. Because I've recently started a month long session of the 5 day a week, 8 hour a day type of schooling. Which means I spend 40 hours a week with my class. This ain't no J-School class. There are no balanced, informed political debates. In our "Politics for Nursing" class someone asked what a premier is. Not WHO the premier is, that's kind of understandable, names are easy to forget. WHAT the premier is. Yesterday our class on liver failure began with the world's dumbest girl talking for 10 minutes about how she'd gone to a question forum with the candidates for our riding and no one should vote for the liberals because he was rude with the other candidates. Not that the liberals plan on cutting health care (sort of a nursing concern) or that the NDP is the only party that really has anything to say about retaining nurses. Just cause he's a big meany pants.

I was almost able to handle it when it was 2 days a week. I went to school, sat in awe at the things people said, came home, blogged about it and then went about my life for 5 glorious days, until I had to do it all over again. Now I don't get that kind of reprieve. And people seem to be taking this opportunity to really show what they've got. There's one girl that talks an average of once every minute and a half. I counted. Not asking questions or participating in a discussion. Just putting up her hand, interrupting the instructors and stating her opinion on everything from conflict resolution methods to abruptio placenta.

There is also the instructor. Or, to be fair, one of the three instructors. Two of them are great and have been my favorites since the first time they taught me. But one of them.....I don't have words. So, instead of a description, I will just post the tally we've been keeping in class:

Personal Stories Told That In No Way Connect to Class : 42
Declarations of Personal Greatness: 27
Excuses For Not Doing Her Job: 17
Mocking Students: 34
Sounds Effects Reminiscent of Epileptic Seizures: 12
Technological Failures: 8

That's in 4 hours, we didn't start keeping a tally until halfway through the last day. That's an average of one inane personal story every 6 minutes. It's fun. I know all about her car, her dog, her husband and the time she went to Disneyland. What I don't know anything about is the stuff that's going to be on my insanely scary 9 hour long exam that determines whether or not I can actually BE a nurse. So that's good.

They make me insane. On reflection, I'm pretty sure I could pull a "not legally responsible" or "way too Eff-ing crazy, your Honor" if I strangled one of them. I'm just still not sure about the morality part of it.

Staying Sane 101: How to Work Nomadism into an Otherwise Functional Adult Life.

I haven't blogged in a while. Somehow having the most free time since the beginning of the year translated into simply not having enough time to blog.

See, I've had 2 weeks off school. I'm only just, this week, starting up another round of staring listlessly towards the front-ish part of the classroom while attempting to keep my brain alive by folding origami paper balls. You can tell I'm thrilled. Anyhow, I've known for awhile that I was going to have those 2 weeks. Ever since I figured it out I've been joyously planning ways to fill them with things that make my heart happy. Here's what I did:

1. Made my parents drive the 6 hours each way from PR to Chilliwack so that I could see them. Visited. Hugged. Even nomads need love. Stayed with my Dad's family. Had a scintillating debate with my uncle about how not all Muslims are terrorists. Was informed that all bad things happen on the 7th of Ed (a month on the ancient Jewish calendar) by my aunt. As she is not actually sure what day on the normal calendar that is I'm deciding to ignore the predictions of doom. Had another debate with my uncle when he threatened to not order me a pizza because I requested spinach on mine, rather than sausage. Apparently vegetables on pizza are "crap."

2. Went to Van and visited B. Ate a LOT of sushi. Drank coolers in the sunshine. Attempted to sunbath in the wind and cold the next day. Froze myself almost to death, but got a sunburn (SUCCESS!). Shopped. Randomly ran into my little sister in La Vie En Rose. Had coffee with her like two grown-ups would do. Felt weird. Hung out with a group of very, very serious kareoke singers. Sang. Did not impress anyone.

3. Went to Tofino for 3 glourious days. Attempted to surf. Mainly failed, but caught one wave on my knees. Loved every second of falling off/attempting to catch waves. Hiked straight down a hill for an hour. Lost shoes in mudhole mid way. Hiked barefoot for half an hour. Got incredibly soft skin. Considered patenting process- cardio bootcamp/spa day. At the end of the hour hiked to the world's most awe inspiring beach. Questioned decision to travel ever again. Pondered possibility of becoming a hermit. Ate the world's best chocolate chip cookies and realized that, as a beach hermit, I would have a difficult time aquiring said cookies. Gave up hermit plan. Sunbaked in first ever bikini!!! Got wicked tan, thanks to recessive Metis genes. Hiked straight back up hill. Died a little and then continued to die for the next week everytime moved legs. Hung out with surf instructors, got very jealous of lifestyle. Learned to sing every single word to Desaparacido while drunk. Now feel fluent in Spanish. Ate life changing sushi (seriously). Learned how to make fruit salsa. Never, ever wanted to leave, but had to as:
a) not a good enough surfer to be instructor
b) selling spray painted t-shirts won't pay student loans
c) job being crazy and stealing empty bottles from people's garages is taken.

4. Returned to Kamloops. Spent almost a whole week recuperating. Watched a lot of movies. Became laziest person in the world and loved every minute of it. Almost bought bike (with streamers on the handlebars) but checked bank balance first. Dream of cruising down road with streamers flying crushed. Then realized that Kamloops is 90% uphill no matter which direction you go and felt better.

5. Went out to Barriere to visit second family. Went to Pow Wow, watched very cool native dancing. Ate bannock. Was, apparently, there to be hooked up with future husband (according to second mother) but didn't know that, so failed to fall magically in love with anyone. Got drunk. Very drunk. Somehow managed to explain single transferable voting to my second mom while shloshed. Very impressive, as I don't actually understand it when sober. Pet the dogs, threw the tennis ball for them a thousand times. Sat in the hot tub once, for five minutes, before getting way too drunk to handle hot water. Ate chocolate for breakfast (it kills the hungover shakes).

So. That's what I've done. You can see I've been far too busy and important (read: hungover) to blog. I anticipate a much better blogging to time ratio in the next three weeks....I'm tired of playing hangman with whoever is sitting next to me and plan to bring my laptop to class and play hangman online instead.