Sunday, March 30, 2008

Spring Break is over!

At the moment I am enjoying my last few moments of solitude before my children come blasting through the door. I am happy that they are coming home, but at the same time a bit sad that I am losing the special time that I have had since they have been away. In the time they have been gone I haven't cooked any meals or washed any school uniforms, (shame on me!) I have slept at my leisure and walked around in nothing but my underwear. The phone hasn't been ringing off the hook. It has been really great. I have so much catching up to do with the kids.

My son called me Saturday night because his Dad decided to go out on the town and leave him at home with his rarely sober, former convict and recently devout Jehovah's Witness sister. When she gets drunk, she becomes very critical and mildly violent. She came up from her basement apartment to chastise my son for cheating at Monopoly. She didn't hit him, but he felt like she might start yelling at him and God only knows what that could lead to. My maternal instincts directed me to get my son and bring him back home. My son wanted me to do something, but he did not want to come home. So I called my ex-husband and interrupted his "party" and of course this was not to his pleasing. I have made the administrative decision to make my son stay home for a while.

My daughter spent the entire Spring Break with her Grandmother. I haven't spoken to her Grandmother for pretty close to a year because she was upset with me for making some disparaging remarks about her son, (my daughter's father) after which she made distasteful comments about my upbringing. Basically, she did not want to accept the fact that her son misappropriated our finances and instead of being accountable for his mistakes he wanted to move back home. She claimed that she wasn't getting involved, but I advised her that letting him come back home and hide from his problems was getting involved. She felt that I should just work the overtime to make up the lost money and get over myself. Needless to say, he's back living with his mother as we speak and she couldn't be happier to have her man back! The whole time my daughter was gone she might have talked to me twice. I was a little hurt because I thought we were closer than that.

The dog is so bored. We have spent a little bit of quality time together. On Thursday he gets altered and gets a few of his baby teeth extracted. I was told by the vet assistant that the surgery will make him a much happier boy. Is that really all it takes?


DiVa...all studied out!

Sunday, March 23, 2008

More Avoidance Behavior

I don't want to study for my Pharm test. I don't. I want to watch reality TV and play on the computer all day. I want to yell at my ex's. I want to have safe sex at a five-star hotel with my lover Terrance Howard. If he is too busy I'll settle for "The Rock." Silly isn't it? I want to smoke cigarettes and eat Snicker bars with a blatant disregard for carcinogens, caloric intake or fat grams. I want to binge drink, sleep til noon, wake up and start all over again. I want to call up people and tell them exactly what I think of them. Yah bitch yah! The last thing I want to do right now is study for my test...

It's Easter and my kids have decided to spend the holiday with their grandmothers. Gives me plenty of alone time to sing the songs that I want to sing, but I can't because I have to study for this stupid test. Friday night I was in a huge depression and my friend called me and talked me into going out which was good because I felt so much better getting out of the house, but it also sucked because I lost my damn cell phone. All of my important phone numbers...gone! I guess I can't complain too much since I was able to buy three cell phones for $240. That's right all the kids have a phone now. No excuses for not knowing where they are now! I am seriously entertaining the idea of getting rid of my land line altogether.

I am supposed to be heating up my store-bought Easter dinner. I bought one because I thought that it would be just me and the kids and I knew I wouldn't have the time to put together a huge meal. The ham is going to take the longest. I could probably heat everything else in the microwave. Alright, time to get motivated!

DiVa...Happy Easter Y'all!

Saturday, March 22, 2008

Defending my future credentials

My preceptor at my nurse practitioner clinicals is very cool. She takes time to teach me what I need to know to be a detail oriented practitioner. Not only that, she takes me to all of her drug-rep sponsored seminars which prove to be educational and serves as a networking opportunity. At one of the seminars, I met this woman who is sharing my preceptor with me. At first I thought she was a very nice person, but then she said something that made me think that she is prejudiced,(my grandmother's way of saying bigoted or mildly racist). The first comment that she made that gave me that impression was when she said the the preceptor does good work for "those people." Generally when people say "those people" they are referring to minority people, specifically black people. I thought, maybe I am being a little sensitive, give the bitch a chance...

So recently, we were at another seminar when she decided to rank on my credentials taking offense to the Doctor of Nursing Practice (DNP) degree I am currently pursuing and researrch interests. I look forward to the opportunity to educate people of what the DNP is all about. The DNP is a terminal degree in nursing, like the PhD. The only difference is that the PhD in nursing is a theory-based designation and the DNP is a clinical practice-based designation. People (like this snob) are making a whole bunch of noise about the validity of the DNP with the thought that it is to make nurses like MDs.

DNPs have absolutely no desire to replace the doctor. As a matter of fact, DNP's cannot use the title "Doctor" in the clinical setting to avoid confusion. In my experience of observing the Nurse Practitioner I would agree that they have all the rights and priviledges of a doctor, even at the master's level. The addition of the DNP is to create leaders in the clinical arena of nursing. It is an academic distinction. I would not want a PhD to perform surgery on me, I would not want a DNP to perform surgery on me unless they were MD's with surgical training. Period. Let me elaborate...

There are one of two tracks that can be followed at my educational institution, a managerial clinical focus and an educational clinical focus. At the end of our doctoral coursework instead of doing a dissertation, we can either do a thesis or a project. The project involves taking another nurse's research and implementing it into practice. Some DNP's are nurse practitioners, others are clinical nurse specialists. Not to complicated, right? I think the bigger issue that is fueling the whole debate about the DNP is the fact that the ANA is pushing the DNP to be minimum requirement for Nurse Practitioners by 2015. Many people are under the impression that master's level nurse practitioners would be grandfathered in. I don't know anything about that.

I mean, at one time it was thought that the the BSN to be the minimum requirement for registered nurses and we all know that will not be happening anytime soon, not with the nursing shortage. Here's an arguement with a bit more relevance. There was a time in history when nurse practitioners were registered nurses with a certificate. There are many nurses are in school right now to get their credentials (bachelors and masters or both) to continue to work as nurse practitioners. That's right, back in the day all you had to be was a registered nurse with a certificate, no bachelors required to be a nurse practitioner! I would not be counting on that whole grandfathering thing.

Anywho, this lady is just bitter. She has low self-esteem and feels a need to pick on people to make herself feel superior to others. I'm not the one. Being in this position is a gift. I am in a position to represent minority nurses and dispel myths. My research focus is going to be related to health disparities in th african american community. I could tell that she disapproved but I don't care! I am going to change the world. Just watch, if you don't know me you will! My nursing work will be world reknown. Now I just need to pass my Adult health course...

DiVa...shakin' those haters off!

Saturday, March 15, 2008

I'm gonna kill that boy...

Things are going okay. The men of my life are actually cooperating with each other, (amazingly) and my daughter's father came to pick up both kids at around 4pm. He was going to meet my son's father so he didn't have to drive 45 miles to come and get him. Very nice, except my son was not home yet and he missed his ride. Not cool. I know he was taking a different walk home from school besides the dangerous way I told him he could not go anymore and I figured that was why it was taking a longer time for him to get home. 5pm rolls around, no son. At 6pm I decide to start looking for him.

I went to his friends' house and they told me that they hadn't seen him since after school. Where does a 13 year old boy go after school for 4 hours? From 6pm to almost 8pm I was canvasing the neighborhood looking for my son. No one knew where he was. His sister didn't have any ideas that panned out. I went to his "so-called girlfriend's" house, I stopped by every group of kids in the neighborhood that was outside playing and asked if they had seen my son, no one had seen him. I went from the north side of town to the south side of town looking for this boy. I got frustrated and went to the police department and placed a missing person's report. I got tired of waiting for a cop to come and wait on me and left to go look some more. I was losing daylight and I wanted to find him myself. I went to my mother's house, she hadn't seen him. She started asking me if he was depressed and if he had money. I did not want to think that way, I had to hurry up and get out of her house. I went back home and checked again, no one home.

By this time, I had called and cussed out both my son's father and my daughter's father. Surprisingly, I did not feel better afterwards. Everyone in my small town had started looking for him. His Dad's friends were looking for him. My daughter's father was on his way out here to help me look. My Dad was helping me look. My sister called the mall and had him paged. One of the kid's Mom's had all the boys' phone numbers. I felt like an idiot, I knew nothing and I was freaking out. Back to the police station. They give me a form to fill out that gives them permission to arrest him if they find him and they took a description. I was on my way home to get a picture of my son for the officer when the cell phone rang. It was my mother. She said, "I was on the computer and this MySpace icon came up and said he is online. How do I respond to him?" I knew he was at home.

When I opened the door, he looked at me and said "Hey, where have you been?" Funny he should ask. I was so mad at him. I called the police station to call off the search. I called everyone and thanked them for helping me look for him. I had to get that boy out of the house. His father arrived shortly after I found him and they went off to his house for the weekend. For about 15 minutes, I thought for sure he was dead. Especially when the officer started asking me about his dental records. I started wondering if he was using drugs or having sex. We are very close and we talk about everything. Why couldn't I pin down his were abouts? Where was he?

The whole time my son claimed to be at an after school basketball game that he swears he told me about. He mentioned that he wanted to stay after school and play basketball, but he neglected to tell me that he was going on Friday. None of his friends were at this basketball game, just him, two other students and a teacher. He swore that his friends knew where he was. I don't understand why he would walk all the way home and then turn around and go back to the school. Somebody is lying. Needless to say, he is not allowed to stay after school any more. And I have to get this kid a cell phone. The punishment will have to wait until he returns home. I need to take some time to think. I also might need to hire a person to look after them for the 2 hours after school that I am not here. Silly, but he can't be trusted.

DiVa...I don't like teenagers!

Saturday, March 08, 2008

It's March Already?

Damn, time is flying. Over the past few weeks I have been going to clinical, attending class, writing impossible papers and having panic attacks. Clinical is more fun than I ever expected, but it is a huge responsibility. The clinical that I work in is a community health clinic that takes appointments and walk-in's. Most of the patients we see are Federal Subsidy, which means that they have no insurance. Kind of sad, but we don't turn anyone away. It is amazing the volume of people we see for STD checks. Nobody uses condoms these days. I would say the other two top diagnoses are Hypertension and Diabetes Mellitus.

I am becoming proficient with the female pelvic exam, which is good considering that I plan on specializing in Women's Health. Men pelvic exams are still pretty uncomfortable for me. The first one I observed was a guy, he was probably 24 years old. His chief complaint was stomachache. My preceptor is a no nonsense kind of practitioner when it comes to guys with STD's. She starts out asking him about his stomachache and he asks where the regular Doctor is. She says, "I'm here so what is it?" He said his girlfriend said that he should go to the Doctor and get checked for Chameleon. It was almost cute, but the Nurse Practitioner didn't crack a smile. She directed him to drop his pants and underwear to his ankles. She started out palpating the lymph nodes in the groin, checking the spermatic cords and testicular descent/masses. Then she checked for urethral patency and took two LONG Q-tips and inserted them into the urethral opening about an INCH! I felt sorry for him, a little. She chastised him sternly about using protection all the time and the dangers of Herpes and HIV. He half listened and walked out with his prescriptions.

I still feel a little apprehensive about taking care of Diabetics. I am afraid of insulin and what could happen if they don't take the medications as prescribed. The one thing I can say for sure is that in primary care you get to spend as much time with the patient as you want. I can take as much time as I need to to put together a plan of care, but at the same time the longer it takes for me to see a patient, the longer it takes to clear the waiting room. I will be glad to get to a point where I can go into a patient's exam room and do a focused exam without forgetting anything (right now I run back and forth between the office and the exam room for missed info!), and I want to be able to write a prescription without having to ask what drug would be best all the time, Oh and I want to not be afraid of Diabetes. All these things will resolve with practice I'm sure.

I am on my own again. My mother got mad at me last week because she was not being very nice to my son and I called her on it. Then my sister had the NERVE to get mad at me too. I don't ask either of them for shit. Now my ex has this new baby, there is zero likelihood for him to sit with the kids when I work late. My daughter's father was useless when he was here, so I don't expect anything special now. I think he moved out just so he could buy the X-Box 360 instead of helping with the bills. Whatever...I live for challenges like this, I am re-vamping my life so I can do things without anyone. Still working out a few kinks, but I will get there. My kids are getting pretty good too! I don't have to remind them to get their homework done. I still have to remind them about laying their clothes out the night before and stuff like that. I could really get used to being awake from 9-5. I really need to get organized.

Alright, back to studying...

DiVa...I'm never on schedule but always on time!