NurseDiVa Extraordinaire ...in training!

And now, the moment of truth!!!

2010-05-11T03:41:00.003-04:00

I will admit, I am nervous! The new job starts next week. For the past three years I have been in school, studying hard and becoming the best nurse ever and the moment of truth is upon us: Can I successfully articulate my education into clinical expertise?

I will be embarking on this leg of my journey as a nurse practitioner in a STD clinic that is a branch of a local health department. Since I am still in the process of completing my doctorate, I will be working roughly about 32 hours a week. But I think I should back peddle a little bit so that you have a clearer picture of how I ended up in this position. I would also like to illustrate how my higher power aligned this opportunity, I still can't believe it myself!

I was applying for positions and as you know I am an FNP. I wanted more than anything to be an internal medicine nurse practitioner (with an HIV specialty) at the local free clinic or at a homeless health care clinic doing outreach work. (I chose family as a specialty because I have a plan to do Doctors Without Borders or Peace Corps when my kids are all grown up). A good foundation would be a position in Internal Medicine or Family Practice. To work in primary care most of the units want 2 years of nursing experience.

You see, I have only been a nurse since 2006. And I only practiced for a year and change. I basically had no nursing experience so to speak. But, I worked in sales for many years...I can sell ice to an Eskimo ;) I was offered a position in 2 units: A neurological specialty and internal medicine. There was just one catch: They wanted me to work five days a week, 8+ hours a day with an occasional Saturday and they couldn't promise me a schedule that was not more than 40 hours weekly. I quickly calculated that I would have to not only meet the learning curve, but I would have to manage the demands of a strenuous schedule, mother my children, manage my household and also work on finishing my doctorate. I could have managed it but, I would be so overwhelmed!

As I was calling to plan my interview for the internal medicine position, I happened to ask the recruiter if there might not be a position in Infectious Disease. She said that she just had a position come across her desk for a nurse practitioner in, you guessed it: Infectious Disease. 32 hours a week, working with STD's, the staff willing to teach a new nurse practitioner the ropes. As a matter of fact, she gave me the phone number of the collaborating physician and encouraged me to call immediately. The MD and I talked on the phone for like an hour! While I was on the phone, she scheduled my interview and a tour of the unit for one week later. When I arrived at the unit, I learned that half of the staff were people I worked with when I was a clinical instructor (I'll have to tell you that story one day as a throwback). Luckily, I had a really good relationship with the staff in clinic and they were excited to find that I was interviewing for the clinician job. A week or so later, I was offered the job!

I know that this position is a narrow application of my skills and my goals as a clinician are so much more loftier than where I am starting out. For now, I believe that this is where I am meant to be! This position is in my area of interest and my new superiors encourage my academic pursuits...They love it that I am working on my doctorate! It is only the beginning :)

Always,
NurseDiVa

I really need to chill out and also get motivated!!

2010-04-29T09:15:00.002-04:00

I have completely lost my motivation to write my proposal. Seriously! In the beginning I was so excited and energetic. I wanted to get a committee together and change the world. Then I met the red tape of making appointments, inexplicable delays and people deciding at the last minute that they don't have the time or expertise to help me with my study. The first draft of my proposal was the final project of the last course of my doctoral degree. I got a 'D' on my proposal...Yes folks, a 'D'!!! I received the first 'D' of my collegiate academic career on the 'crown jewel' of my studies, which resulted in the first and only 'C' as a final grade on my college transcript...At which point I just put on my big girl panties and said "Screw it!"

I can't write a decent literature review to save my life. I had to change the study...Well not change, just make a few minor adjustments. Thank GOD it doesn't require a whole new literature review! I have to change my theory, (not really a big deal) but after the horrific feedback that I received from the last person that reviewed the draft of my proposal I have just felt my confidence sink to an all time low. I guess I just need to whine. I have tried Vodka, chocolate, sleep and a chat with a therapist...I still feel poopy :(

I think what makes this 64 page masterpiece so overwhelming is that it is a 64 page fiasco. Today, the goal that I am setting between me and my chair today is to break this monstrosity into small digestible portions so that I can reduce my anxiety. The next step is to talk to people in my community who can realistically help me plan my intervention. I have been doing a bit of research in this area and was disappointed to find that there has already been a project of my kind done...However, no one has published their findings which I find to be somewhat comforting.

Being a bit of a trailblazer is HOT! But this is a lot of work (I am making excuses!!!) I don't know where to start, (lie). I need some guidance, (now you're talking). Perhaps today's meeting will be insightful, (let's hope so). I want to graduate in August (we'll see about that). Hey...It could happen!

My Adventure with FNP boards ;)

2010-04-15T09:54:00.006-04:00

The past year has been so very busy. I completed my Masters and (next week) I will have finished my Doctoral coursework obligations. I opted to finish all of my doctoral courses before taking my Family Nurse Practitioner Boards. That was kind of crazy given that I have 'poor test taking skills' but it was what I needed to do because I didn't have the money to pay the exam fees. I had been away from the content for ONE YEAR and I managed to pass after only studying for TWO WEEKS!!! So there...I control my own success and failure ;) Because I was unable to find anyone else's study plan for boards, I have decided to post mine...

To prepare for boards, I spent a total of $52 and I used only three items. I studied using the $40 Fitzgerald book and the sample test questions posted on the ANCC website. I surveyed the Fitzgerald book chapter-by-chapter in order from 1-15 (This is important because one chapter leads to the next in a very methodical way). I also used (borrowed from a friend) the 2005 ANCC guide, but for the information on Theory/NP Practice, as a reference to the Fitzgerald and for the questions in the appendix. If you can't afford to buy the ANCC reference manual, try to find one of your nursing texts that covers NP practice, family theory and health care policy for the purpose of review. This is how I did it:

Step One: Answer the questions that proceeded the content in the Fitzgerald guide

Step Two: Read the content...The Fitzgerald book is a very EASY read

Step Three: Create flashcards based on the Fitzgerald content using plain 3x5 notecards. After I used notecards for the first two chapters, I decided that it would be better to make powerpoint slides so that I could put them on my Blackberry. As I made the flashcards, I read the questions and then the correct answers ALOUD

Step Four: Find some more practice questions. I found mine in the ANCC guide and on the ANCC website. I did these questions and my flashcards over, and over, and over again. I used the adult, peds, gero and family ANCC sample questions on the website. This proved to be helpful in learning the flow of the questions and building confidence.

For two whole weeks, any spare time I had was used to study the Fitzgerald book, doing about one chapter a day. I woke up with that book...Laid down with the book...I even loaded the questions onto my Blackberry so that I could practice questions whenever I was idle. An amazing source of support during my studies was my daughter's father...Yes,I have vilified him in the past, but he kept an eye on the kids, made sure I stopped to eat and made me take sensory breaks (Like going to see 'Why Did I Get Married, Too). When I wanted to fuss, he let me. When I wanted to give up, he encouraged me. The morning of the test, he prayed with me. I guess he is not ALL bad.

When I arrived at the testing center I was terrified. I placed all of my items in my locker and checked in...I was a nervous wreck. I completed the tutorial and proceeded to take the test. The first question popped up...I didn't really know the answer. It was in that moment that I decided that I would 'mark for review' every question that I thought I missed. The first 7 questions I marked. Then finally I started to get questions that I felt pretty confident about. I was moving along at a pretty good clip! Then I got to the last question and I though..."Could it be over that quickly?' After I counted the questions that I 'marked for review'...There were only about 50 questions. Not Bad :/ So I went back through and reviewed the ones a thought I missed. I might have changed a couple since my nerves were a little more settled...I had plenty of time, at least a hour and a half to review my questions. Then I said, either I know it or I don't. I decided to end my test. A survey popped up and then I was directed back to the proctor.

I walked out and asked, 'Did I pass?' She said it depended on the print out. I was feeling sick! She had to re-boot the computer because my paper didn't print out. I was hoping that didn't mean I would have to take the whole thing again. After about another 5 minutes, the paper printed and I found out that I passed. I am a ANCC Board Certified Nurse Practitioner! I don't have my state license yet because it requires me to complete paperwork. The test was not so bad after all :) If you are reading this and preparing for boards just breathe and be confident that you have all that you need to pass...I am sure you will do just fine!

Now to get my proposal written so that I can get my study moving!

NurseDiVa MSN, FNP-BC

Links

Tough Times...

2009-09-02T11:51:00.002-04:00

I am feeling lost...This whole doctorate thing is becoming frustrating. I still don't have a committee. Papers are coming due and I don't have the energy to follow through. I don't want to do this degree any more. I am dealing with motherhood stress, financial stress, school stress, love-life stress, self-esteem stress and I am just tired of it all. I have no energy and I just feel alone. No one seems to understand. I am the first in my family to pursue a terminal degree and when I try to talk to someone about my troubles, it is always looked upon as me trying to one-up someone. I just wish I could be done and doing the things I planned to do to change the world.

I would cry, but it is a waste of tears. I would scream but what is the point of that? I would quit, but I would be mad at myself in the long run. Other students in the school get attention and support. I have been on my own from the beginning. My advisor keeps saying that she wants me to call her if I feel lost. My thought is 'why should I have to be the one doing all the calling?' They gave me the opportunity to return to school, would it be too much to ask to have them occasionally check in on me to see how I am doing from time to time? Why is it that I have to call and make an appointment with the administrative assistant to discuss my study? Why can't I just make an appointment with you personally, Dr. Thus-and-Such?

Yesterday, a prof asked me why I decided to pursue a doctorate in the first place. I couldn't really tell her. I forgot why I wanted to do this! My family keeps asking me for money. Fifty dollars here, twenty dollars there. A few weeks ago, a relative of mine who is living with AIDS asked me to help get him an appointment to get him back on track. I asked one of my esteemed colleagues to see him and he went to the doctor's office and showed his ass. The bank assessed NINE overdraft fees because they imposed a 5 day hold on a $400 check. When I challenged the $456 in overdraft fees, they only reimbursed $125. I owe $550 to the electrician who switched my fuse box to breakers, $270 for the fees associated with my FNP licensing exam and I still haven't paid my car note. I need an escape...The DiVa is having a really bad day...

DiVa...is wondering how she can empower other women if she is feeling so weak ;(

Finally, the last of my doctoral coursework is complete!

2009-08-30T21:41:00.002-04:00

A few weeks ago, I completed the last of my doctoral courses. It feels so good to be done with the actual lectures and classroom stuff, now it's a matter of finishing the projects. My challenge at the moment is completing the written proposal, the data/code book and putting together a committee with synergy! Then I can prepare for proposal defense. I plan to have my data collected before the end of the year...that way I can graduate from the program next May and enter the health care arena as a practitioner of some sort before I turn 40.

About the whole becoming a clinician, I have been thinking about that quite a bit lately. I am an African American woman. In our country, many have preconceived notions about what it is to be black in America. Many of the policies that affect black people are based on these notions. As a researcher, I will provide scientific evidence to things that fellow African Americans know as common knowledge. Through research I can give a voice to those who cannot speak for themselves. It is important to make opportunities like mine available to ALL African Americans. I think it will take more than just money because some of us need a little nudge to get moving in the right direction. I still want to be a Family Nurse Practitioner, but I also want to be a researcher and a nursing educator...Nurses can never stop moving!!!!

Class is back in session

2009-07-20T02:54:00.002-04:00

Sunday was day one of 6 days of class. Eight hours, every day!

The first class is about evaluation and the second is action research. I had a little run in last semester with evaluation. A prof gave our class a total of three hours of instruction and three assignments. The assignments came without any supplementary reading. The prof offered no office hours. She only allowed communication by email on Wednesdays. I was determined not to let this negativity stop me. I turned in my assignments and waited for the results.

I was told that I had an 88.5%...I failed one assignment because she said I turned it in late. I provided hard evidence (time-stamped email confirmation from her)that I turned the assignment in on time and then she told me that I failed not because I was late, but because I did not meet the course criteria. You can't change your mind!!! When I tried to enlist the support of the administration, I was told to simply let it go, there was only a certain amount of attainable A's per class but not to worry, in my doctoral courses there will be no limit to the number of A's that can be issued by a prof...WTF? As I recounted the story, it pissed me off all over again. I was fuming for the rest of the day. If I weren't being sponsored by the federal government to attend this school I would have quit on the spot.

To this day I have yet to see my paper to find out what I did wrong...I wonder if I did anything wrong to begin with? I learned a valuable lesson! With the Advanced Research class that I am presently taking we had three assignments, an article critique, a literature review and finally our written proposal. I turned in my article critique and the literature review. I happened to check our online grade book and noticed I was assigned a grade for the critique, a BAD grade. I had already turned in the literature review, which meant 2 bad grades. I decided to take charge of my evaluation. I sent the prof an email advising her that I needed an extension for the written proposal until I received feedback from the literature review, because the literature review was a HUGE part of the proposal...She could have failed me if I had just let her continue to evaluate me without feedback!!!

I will say that being in this class with this prof has restored my faith in the academic system, so far...I will be optimistic!

~DiVa

Thanks 'areader' for your friendly reminder!

The ladies at the disco club...

2009-06-24T08:20:00.002-04:00

Last week, a friend of the family came in from out of town. She is a little younger than me, by about 10 years. Since I have time, I was enlisted to entertain her and her friend. The focal point of their visit? To visit with our family of course, but most importantly to find a MAN! That gender ratio disparity rears its ugly head...There are 10 women for every man in the United States, so they can pick and choose and they know it!

One night, we decided to go to the club. The first place we went to was more like a bar, with men who were not really attractive but they were okay. I guess I don't get excited about men like the younger set :) And then the next bar that we went to was basically ALL women! The women seem to be my age or a little older, but they too were on a mission. The dance floor was women dancing like they were in a strip club...and the five men that were in the club stood at the edge of the dance floor enjoying the show...

Afterwards, we found a club that was open until 5 am. The door policy was crazy: no gum, no bottles, no lighters, no cigarettes...the only thing you could take into the club was a smile. Once we cleared security, there was a man with a cash box. The cover charge was $10. Too much money in my estimation of things, but the kids wanted to go...so we went! The club had 2 levels, the lower level was empty but you could hear music booming from the rafters. We ascended the staircase to find hundreds of kids bumping and grinding to the beat of rap music.

Some girls were dressed modestly, with floor-length sundresses and sandals or jeans with a cute t-shirt. Others in bootie shorts and dresses just long enough to fall below their buttocks with 4 inch heels. The young men were dressed in the finest urban gear, standing in groups with their friends testifying to the lyrics of Lil' Wayne..."Cuz we like her, and we like her too." I was surprised, one of those young dudes asked me (the senior citizen of the group) for my phone number!

Anyway, as I sat back and observed the events of the evening I realized something, these are the people that will benefit from my study. I wondered, does that young lady who is bumping her butt up against that guys crotch know her worth? Does she realize that she is beautiful? Does she protect herself and is she aware that she is at risk? And when I saw that young man, standing at the bar sippin' on his Corona I wondered if he will respect her in the morning? Will he insist that they use a condom? Does he like to sleep with men, but is fearful of the stigma that comes with homosexuality?

NurseDiva...That's what happens when a researcher to a nightclub!

Hey man, this isn't supposed to be about me!!!

2009-06-09T09:29:00.002-04:00

In my quest to study HIV/AIDS as a theme for my doctoral project, I have enlisted the help of a local nursing expert in the area of infectious disease. The expert is an amazing woman. She came to one of our classes in women's health to discuss the impact of AIDS in the community. I was impressed...

Initially, my interest was to study the paucity of data regarding the relationship between knowledge, perception of risk and high risk sexual behavior of African American men aged 27-50 who seek casual sexual encounters with women using social networking sites on the Internet.

In English: I want to know what black men know about catching a sexually transmitted disease, whether or not they think they are at risk for catching a sexually transmitted disease and how that information affects their sexual practices.

When I broached my nursing profs with the research idea I developed, they gave me discouraging news. How would I get the IRB to approve my research using the Internet? There are no doctorally prepared nursing faculty who study Infectious Disease...Who would be on my committee? Maybe I should change my foci...NOT! So, I wrote a letter to the local expert begging her to be on my research committee and to mentor me so that when I am done with the fellowship, I too can be an nurse expert in the area of infectious disease. I could have fainted when she said yes!

The first time we met, she was feeling me out to see how serious I was about studying HIV and what I already know about the population. I had to admit that I knew nothing and that I was hoping that she would put me in the right position to get the exposure I need to develop a good study.

She basically told me that I had a group of subjects sitting right in my lap...My friends! African American women who are my age are the fastest growing number of newly diagnosed HIV in the country...but I wanna study men!!! She gave me a 10 article reading assignment on HIV/AIDS among African American women and scheduled a meeting to discuss what I have learned.

I read the articles and didn't learn anything that I didn't already know. But she posed some questions that made me feel a bit uncomfortable.

Do I think that I am at risk for contracting HIV?

Why don't I think I can contract it?

I have children, which proves that I have unprotected sex...that clearly makes me at risk. And what makes me think I should trust my partner?

Now she did not come right out and ask in that order, we had conversation in between. It really made me think:

'Why do we trust who we trust?'

'Why are African Americans the highest group? What does our population need to get the wake-up call?'

'Is the little 15 minute sexual encounter worth risking my life over?'

'With the numbers growing so fast, why don't we know more people who have had a close call...a diagnosis...or even died of AIDS?'

I have donated blood, but I have never had an official AIDS test. I could be HIV positive!

Ugh, now I am thinking about changing my research question...but I won't because there is something about my discomfort that intrigues me! I want to do a study that is interesting but will also help my community. This is hitting too close to home. This isn't supposed to be about me...but I realized that whatever I study is about me!

NurseDiva, the nursing scientist....Lol!!!

2009-05-21T06:53:00.002-04:00

Everything is happening so fast. BSN, then MSN, apply to take boards and doctoral intensive courses. My head is spinning! But I will break down what I am doing so that it is more easily understood. To be honest, I just learned it myself :p

The first course that I am taking as an official doctoral student is advanced research. The goal of this course is to develop your research problem, research purpose and research question that you would like to study. At the end of the class you should be finished with the first three chapters of your written proposal, which includes you literature review. The literature review is when you go to the library and look for scholarly articles that support what you want to study...basically you are looking for proof that your study has NOT already been done :)

The written proposal is like asking the project defense people and university for permission to go forward with your experimental study. If they say yes, then you go to the institutional review board, which is a panel that reviews studies to make sure that they are ethical...an example of unethical would be like the Tuskegee experiment!

So I have been developing my research problem and I am stuck. I will share my ideas and if you are into this sort of thing maybe you can give me some feedback. Or if your are not, you can just tell me if you think it is cool or not! I am not afraid that my idea will get stolen because if you can make something out of this you are freakin' awesome!!

My research interests include: african americans, health disparities, education regarding std transmission, HIV/AIDS, health promotion and health protection.

Research problem #1

The research problem being investigated is the relationship between motivation and adherence to the plan of care in African American populations with chronic illness.

In English: I want to know what will motivate black people with hypertension, diabetes or HIV/AIDS follow the instructions given by the clinician. I say clinician because Nurse Practitioners are the future of primary care!

Research problem #2

The research problem being investigated is the relationship between knowledge of sexually transmitted disease transmission and high risk sexual behaviors of adult men on social networking sites.

In English: I want to know if guys who frequent websites like MySpace and Tagged know how STDs are passed from one person to another and how that knowledge speaks to their sexual behavior...are they more high risk because they don't know how diseases are passed?

I have a meeting with my prof to find out whether or not either of those studies will work. I think this research thing could be FUN!

Well, I guess I should get my kids ready for school...

I'm still here!!!

2009-05-19T22:05:00.003-04:00

I have missed blogging. Blogging was a therapeutic outlet for me to share my feelings. It was all fun and games, until my ex found it and confronted me about all the things that have happened over the last four years! It was kind of funny at first, but then I felt bad. And then I thought, well hell it's the truth so he'll get over it!! So I'm back!!

What have I been up to lately? Well, there have been a variety of things that I wished I had blogged about and didn't so I will get you up to speed. The last post that I wrote was about my adventures in billing. A funny thing happened with that class. The teacher only taught the class for one hour and refused to give office hours. She would only answer questions via e-mail on Wednesdays. I was pissed. So I did my assignments to the best of my ability and waited for my grades. I received an 88.5% as a final grade. I received an 'F' on one of my assignment because according to her I turned it in late. I knew that this prof was going to be difficult so I planned ahead. When I turned in my paper, I asked her to send me an email to let me know that she received it, and she did. The timestamp on the email was at 8am on the due date. I sent proof to the prof that my paper was on time and she said that she really meant to say that she was giving me a 'F' because my work was of a poor quality. That made me go to the dean. I explained the situation and waited for a response. The response? She said I had to take the 'B'...ain't that a bitch? The reason? Because it is not important for me to get an 'A' it is important to finish the semester so that I can graduate and sit for boards. I was so pissed, I stayed mad for 3 weeks! I wonder if they would be as lenient if I accidentally plagiarized?

Speaking of graduation, did I tell you? I graduated on Sunday!

I am officially:

NurseDiVa, RN, MSN

Next stop: boards and the completion of my doctorate. I plan to take boards in July. I have been practicing my new signature all week! But there is no rest for me, I am already back in class! At the moment, I am working on my doctoral coursework. Yesterday was my first day as a REAL doctoral student. The first class is a research course. In this course, we are developing our written proposal for our doctoral project. I have not finalized my research problem but I understand how the development process works. Which I think is a good start :)

Since I have been a doctoral student, I have met some really nice nursing leaders. One is a Midwife from the southeast and another is a Women's health NP from the southwest. Then there is one from the Midwest who is in management, one from the southeast who is a Family/Psych NP and one who is a nurse attorney! All of the nurses in our classes, (except those of us who have limited nursing experience) are amazing advanced practice nurses from whom I hope to learn. They are nursing leaders from all over the country.

Who would have ever thought that I would be where I am today? At graduation, one of my nursing mentors suggested that I will be working on my PhD. I laughed, but now I wonder if I really WILL be working on a PhD!!
Nah...

Since I am not ready to tell you to your face...

2009-01-26T23:00:00.002-05:00

I will tell the world!

I have been a great friend to you. When we worked in Labor and Delivery together, our co-workers treated you like poop. I listened to you cry. I fixed your mistakes and watched your tracings so that you wouldn't let your patients hyper-stimulate. It was I that defended you and tried to make you feel like a member of the team. I was so excited when we received the fellowship together. It seemed like the start of a beautiful friendship. But there is one thing that I have taken for granted. You have no idea what it means to be a true friend.

My first semester of the FNP program was challenging. I had been out of school for a year and a half. The L&D job was hard on my feelings of confidence and self-esteem. And it didn't help that our assessment instructor called me 'fat' in front of the entire class. Instead of being my friend and supporting me, you opted to kiss our instructor's ass because she was your advisor. I was not saying that you had to hate her because she was mean to me. That's ludicrous! My thought was that since I listened to you vent when you were being ostracized at our previous employer, that when I am having a hard time that you would return the favor. That's what friends are for! But not you. You tried to distance yourself from me. I talked to you about it and I decided that it would be better for me to give you plenty of space.

You understood that I distanced myself from you because of your behavior. You apologized and I forgave because it is who I am, it's what I do. I thought that you truly valued our friendship. I was wrong. The first class we took together this semester we had a group project. It was a spur of the moment thing and we were given an option. Either we could work on the project after class or come in early the next morning and complete our work. We voted and the majority won fair and square. We agreed to stay late. You said you had daycare issues. I understand daycare issues, I too am a mother. But your kids were with your mother and you said that she was understanding.

We offered to let you leave and you chose to stay. You said you only needed to make a phone call. But you had decided that if you HAD to stay, you were going to make EVERYBODY miserable. You disappeared for an extended period of time, then you expected the whole group to wait for you to read the article before we started working on the project. I thought that sucked because you were gone at least 30 minutes. That was more than enough time to make a phone call home. You insisted on doing the powerpoint which was fine. But anytime that we tried to give you feedback about typographical errors and problems with content, you had a very nasty attitude. It was HELL working with you. But you explained your position and I tried to understand. Everyone deserves a second chance. Then there is Sunday...

This Sunday, we had our class that teaches us how to negotiate our contracts once we become nurse practitioners. This was very important to all of us, especially those of us in primary care. We all need to know how insurance covers patients and how to chart so that we get reimbursed. Just because you are a midwife and they bill for your services in bundles doesn't mean that the rest of the class might not have benefited from the content. Within one hour of the class starting, your kids started calling you. And it was for stupid stuff. You interrupted our class to take these phone calls and expected that the teacher wait for you to finish your calls before she continued teaching. That was so unfair and if it were me, you would have said something. I also did not appreciate how you spoke to our classmate, who happened to know the answer to a question that you posed. I know, you didn't say it to me, but I thought that you were unnecessarily mean.

Since the teacher told you that class would be over at 3pm, she tried to rush through the content to accommodate you. That was also bullshit. Our class costs $1500 and I felt that we should be able to benefit from being able to answer questions. You made us all feel very uncomfortable. You should be ashamed of yourself. We came all they way to your neighborhood, which was better than 30 minutes from campus and within 10 minutes of your home. That made the drive almost an hour for me and at least 30 minutes for everyone else. We did everything to accommodate you. And you still had to have it your way. I apologize but I cannot be your friend.

NurseDiVa...

Who is that amazing chic in the mirror?

2008-12-02T03:12:00.003-05:00

Since the summer I have been trying to lose a bit of weight. I have successfully lost around 30 pounds, (not counting what I have regained from Thanksgiving, lol). I am excited because it has been very nice being able to fit clothes that I never realized were really too small in the first place. I am also experiencing the pleasure of buying clothes in a smaller size. But the most amazing revelation I had was on Saturday morning.

After a night of binge drinking I awoke the next morning to find myself completely naked in the arms of a former flame. I have no regrets about that, well maybe one or two but I think that is a different blog post. I crawled out of the bed with a slight headache (or should I say hangover) and a deep sense of satisfaction. As I was headed to the bathroom, I caught a glimpse of a lady passing by the mirror on the dresser. She was chubby, but curvy. I was so impressed that I stopped to take a good long look.

Soft, supple, golden brown skin with a few strategically placed stretch marks covered her ample frame. Obviously, this woman has had a few babies, but despite that fact her breasts have maintained their shape and are still somewhat perky. Her upper abs were beginning to take form and following them to her lower abdomen, there is one moderately sized roll of flesh begins just above her belly button and rests gently on her shapely hips. Moving down from the hips, her thighs were slightly dimpled on the back side of her legs, but the front of her thighs and calves were toned, as though she might have been a cheerleader or an athlete at one point in time.

Her arms are warm and inviting. Very nice shoulders, I thought. Her eyes were smiling although there were waves of disbelief and wonder splashing across her face. As she started to smile at me, it was infectious. So much so that I started to smile back and it was in that moment I realized that the beautiful woman I was admiring was me!

DiVa...Learning to love herself again!

Pinning Ceremony...coming soon to a DiVa near you!

2008-11-20T20:18:00.002-05:00

About 2 weeks ago I signed up for my pinning ceremony. I have decided that this go round I would let my mother and my sister pin me. My mother has this ridiculously low self-esteem. It's like she wants me to 'beg' her to pin me. Dude, you complain that no one cares about you and then I invite you to pin me and you say, "why don't you let you Ex-dude pin you?" I wish I would let that bastard pin me. My sister is having a pretty tough time right now too. I thought it might give her a boost. But the only thing she can seem to do is ask me if I can freakin' babysit. I am so tempted to just say forget it and pin myself. Those two women know how to suck the joy out of anything! I should let one of my readers pin me. Any takers?

Despite all of their drama, I am still quite amp'd about my impending graduation. In May, I will be attending Graduation part 1 of 2. I will be finishing the master's at the end of December, but have elected to walk across the stage in May. Yay me! I never imagined that I would have ANY degree let alone a master's degree or even a doctorate. Dr. DiVa...I still can't see it yet. In the Spring, I start plugging away at my doctoral coursework. I think I might have stumbled upon something I want to study for my project. I think it might be HIV peer counseling. I found this topic while working on a paper for my Health Care Policy class. I have no idea how that I will work that out, but it should prove to be very interesting to say the least.

I think I am pretty glad that I decided to choose Family Practice as my specialty. For a couple of reasons...

1.) I will always be able to find a job
2.) I can work in nearly ANY area of primary care
3.) I will never be bored (hopefully)
4.) When I decide to walk the earth and do good ('peace corps' or 'doctors without borders') I will have the skills to make a meaningful contribution to the areas being served.

There is probably only one disadvantage, everybody seems to think I can cure them. One of my family members asked me to do a pelvic. No thanks, I think I'll pass. Lol!

DiVa...Pelvic exams on family members, definitely doing too much!

Fall, it's a good thing!

2008-10-18T11:39:00.002-04:00

The leaves are changing. I took a walk yesterday to clear my mind. It was beautiful to smell the crisp Autumn air.

Yesterday, I had to go on campus to perform an interdisciplinary exercise with other students from the medical, dental and social work program at our university. The goal of the exercise was to learn how to work as a group to care for patients who need end of life care. It was insightful. People have no idea how the other side lives. One of the medical students asked the dental student if they had dental nurses. That was kind of funny! The amazing part was that the person who asked that question had braces, which tells me that she has at least been to a dentist's office in some capacity. None of them really had any idea what a social worker does.

So we had a mock family meeting to help the 'actress' decide to put her 89 y/o father on DNR/CC code status. What is even more amazing, is that it seemed to me that none of them knew what a do not resuscitate order meant. Come on you guys! We are the future of health care for crying out loud. I was shocked. We are talking about 4th year medical students and 3rd year residents. I felt like an expert and they agreed because they made me the group spokesperson for the exercise. Many of the other students did not realize that hospice has an option for home care. Thank God this activity counted as clinical hours, I wish I could have gotten paid...

Diva...

In a few short months...

2008-09-26T14:06:00.002-04:00

I will be NurseDiva, RN, BSN, MSN, APRN, FNP...

I haven't decided how much of the alphabet soup I will list behind my name. I guess that the RN and BSN part is assumed. So I could probably take that off. And then the FNP really isn't necessary, so I could drop that...So then we are left with:

NurseDiVa MSN, APRN

And in a few short years: Dr. NurseDiVa DNP, APRN

If you follow this blog, you have probably wondered where I've been. I had to go into hiding for a while due to a possible hacking situation. Then I was hella busy with all the demands of clinicals, intensives, papers and family obligations. So now I am back after realizing that this blog served a very important purpose in my life. Even if no one responded, I know that someone somewhere secretly related to me and understood where I am coming from. And all of these feelings I had were getting out. Keeping things inside is not a good thing. Better out than in I always say...

Besides school how are the kids? The kids are great. My son is still in the whole teenage angst stage. I am trying my best not to kill that boy. He is getting taller by the minute. My daughter is becoming a lovely young lady. This weekend she was invited to participate in a pageant. I don't know if I am going to let her do it yet. We'll see...

School is going okay. For some reason, this semester is a bit more relaxed. I have more time to stop and smell the flowers. I took my first doctoral course this semester. In comparison to the undergraduate and even masters level courses, the doctoral courses really give me an opportunity to share my thoughts in class. And this is encouraged and appreciated. The idea is not having one parrot back learned information in the doctoral course. They give you the information, and then you amplify it. Elaborate. I love that. In January, I will sit for the licensing exam. That is when all of my coursework shifts levels from masters to doctoral. For some reason, it is not at all intimidating.

Love and friendships...I have been separated from my live-in love since February. Really, I don't have time for a love life but I do tire of studying ALL the time. I have decided that I want to have more adult friendships. Male and female, because I have realized that the advancement of my education has pushed a lot of my friends to the side. Not by my own choosing, we just don't relate anymore. If by chance one of these adult friends (male) become more serious, then I will be totally open to that possibility. But right now I just want friends, of any gender!

Well, the kids will be home from school soon. I'll be back soon...

DiVa

Slow down, Summer.....!

2008-07-24T14:24:00.003-04:00

I wish summer would slow down, just a little bit. I am enjoying these lazy summer afternoons. I just got my basement waterproofed. It wont be long before my baby girl has her own room. There is still alot of work to be done at Casa de Diva, but time is going so fast, I can't see myself getting all the work done before I (and the kids) return to school for fall session.

These summer classes have been very challenging. I am working on the Statistics final as we speak, (well, not right now because I am blogging). Things are going quite well in general. I am in the middle of my OB/GYN clinical. I am becoming better with my pelvic exam with each passing day. Yesterday, we had a patient that had 2 cervices and a vaginal septum. Basically, she has two openings, two vaginal canals and one uterus, we think. I did not catch it but I did think there was something strange about my patient's anatomy. The patient was having her first pap and was mortified at our exciting discovery. I imagine I would be too. The only thing I need to focus on is bringing all my skills together.

The kids school clothes are already ordered. All I have to do now is purchase supplies, shoes, underwear and socks. Simple stuff like that. I have lost a total of 25 pounds. Working out has become routine, eating healthier is a work in progress. At the grocery store, I ran out of money and had to leave a whole cart of groceries in the store. It was embarrassing. Food has gotten to be so expensive. I hope our new president is going to make things better economically....

Well, I suppose I should get back to work.

DiVa...gonna make this statistics final deadline if its the last thing I do!

Get it together, girl...

2008-06-29T21:16:00.002-04:00

I finished all the intensive courses for my women's health class. I hate to say it but I think I made enemies with the instructor, for reasons beyond my control. I am black. I can't change that. Micheal Jackson can, but I like being black...finally! Enough of my life was spent trying to be black enough so that my black peers wouldn't call me an "oreo" and race neutral enough to make the other kids and faculty at my all white elementary, middle and high schools not feel intimidated. Now I am free to be the only me I know how to be. I love my pretty brown skin. I love having that sexy sassy thing that makes a black woman so alluring. Changing it is out of the question and impossible.

Alright, here's what I did. I was working on a group assignment with my partner. The first assignment we scored a 21/25. Not the grade I wanted but not failing. Now, I could have taken that in stride, but the instructor's feedback was written in a very sharp tone and it made me feel like she thought that I didn't know what I was talking about. She asked for the rationale for my decisions and I gave them in writing. I thought I was being cute and witty. All I did was end up pissing her off. She gave us a 17/25, which resulted in me requesting a meeting. Let's just be for real, I am a DiVa but I don't perform at a 68%...ever! When I met with her she asked that I take of the gloves, which I don't recall having the gloves on to begin with. We spoke in a civil way and I thought we were cool. The next day she made a joke towards me in an attempt to be playful. I didn't laugh at the joke, mainly because it wasn't funny and I didn't think she was talking to me. I was not paying attention, I was digging in my bookbag looking for a plastic spoon! And now I don't think we are cool anymore. I think she attributes most of our friction to me being an Aquarian and she being a Taurus. I don't know much about astrology...

Back to the whole race thing. I have realized something. As a black female I have to take the emotion out of whatever I say or do (unless of course the emotion is positive) because no matter what I do to try and come across as objective (race neutral) I will be labeled agressive just because of the color of my skin.

DiVa...can't we all just get along!

See...I'm even late blogging!

2008-06-22T23:15:00.003-04:00

I am really trying to work on that punctuality thing. I am getting there. Tomorrow I have a huge test, but I decided to hang out with my nieces instead of studying seriously. I tried to study on the beach while keeping an eye on the kids. Not easy.

The lifestyle change thing is going well. I have lost 20 pounds so far! I am not on any crazy fad diets, I'm doing it the old fashioned way. No fast food. No soda or juice. Exercising at the gym 5 days a week. I even bought a bike to ride back and forth to clinicals and to the gym. I figured I could save on gas and burn calories at the same time. So far so good, but I wonder if I can keep this up forever. Lately I have been feeling a little depressed. It's summer, the kids are spending time away from home. I am so busy with school. No love in my life. sigh...

It's for the better because I really don't have time for love. I am working on getting the house remodeled. The finance company is getting all in my business. They asked me for my W2s for the past 2 years. I never heard of that before. So I decided not to give it to them and they cancelled the appointment for the job. I don't blame them, I would want to know where my money is coming from too!

The stats class is going okay. I really didn't expect anything higher than a B in that class. But the women's health class, that instructor has a personal vendetta against me because I was late to class on the first day and I did not suck up. She is so critical when she grades my paper. I know it has to be me because the class average is high and my papers always score so low. The first score was 21/25 which is okay, but now she gave me a 17/25 and that is straight up bullshit. I think it is time for us to meet for coffee so that we can clear the air. I am just going to ask her straight out if she has a problem with me. If she says no then we are cool, but if she says yes we are going to have to talk with the dean. Somehow, someway we are going to work it out. And that's all I have to say about that! Now I have to get a really good grade on this stupid test tomorrow.

Back to my studies...

DiVa

Coming up for air

2008-05-31T17:34:00.003-04:00

It has been such a long time. I miss my weekly journal of my quest to become a DNP. I have been so busy. This program has been so challenging that I only have time for bathing, eating, studying and going to clinical. Beyond that I am an incoherent slob. As much as I freaked out about last semester, I passed with flying colors. Before I could even finish my last final exam, my next set of classes began. Which is my explanation for where I have been for the past few weeks.

This next semester is all about advanced statistics and women's health. Whoopee! Something I marginally know something about. I am also getting my house repaired. The basement is getting waterproofed and I am having new flooring installed. I probably could have abandonded this mess and bought a new house but my rent is 440 dollars. I can't beat that.

I will try to stop by at least weekly. This summer is gonna be AWESOME.

Are episiotomies necessary?

2008-04-01T08:34:00.002-04:00

We were taking a class in suturing yesterday. It was taught by a pharmaceutical rep who obviously never had to sew a human being back together. First we had to watch a video that was made about 20 years ago. The guy was talking about digits and adjacent fingers and approximating. Total mish-mosh. Then the dude stopped the video and we each received a spool of suture and a pig's foot. We had to create an incision on the pig's foot. Then with our needle driver and pickups with teeth, each of us attempted to place stitches using the square-knot technique. I was so frustrated I wanted to pick up that pig's foot and throw it through the window. I hope you guys don't ever need me to give you stitches!

My inner perfectionist wanted nice, neat rows of stitches. What I got instead was loose, floating stitches. Despite that the wound edges were well approximated! Aha! My inner DiVa emerges. I overheard someone saying something about episiotomies being un-necessary. Huh...? This person has never worked in labor and delivery. She is someone that I happen to know pretty well, we are almost friends. She has had one child with which she had an episiotomy, and based on that experience and a clinical rotation in L&D that lasted maybe four weeks her professional opinion is that an episiotomy is un-necessary? Let me retort. Episiotomies ARE necessary in certain circumstances.

Now, if a lady is having her first baby and has been pushing for all of five minutes and the physician says, "Let's cut an episiotomy." I would say a resounding NO. Give her a chance. Pushing is truly an art. You have to be able to coordinate your breathing and get into the perfect position. A little perineal massage with mineral oil or surgi-lube would also help. I have had an episiotomy, and I know how bad it hurts. I was not given a chance to prove myself in the pushing department. In that case, an episiotomy is more for the convenience of the physician than anyone else.

On the flipside, if Mom has been pushing: 1. for an hour or more, and the physician has assessed the perineum and it is obvious that there is no room for baby to rotate, descend and emerge OR 2. Baby is in distress, is in the perineum at a very low station, we need to get the baby out NOW and a c-section can be avoided OR 3. Mom is not going to stretch, has already started to tear a little and we are trying to run damage control 4. We are having a forceps/vacuum delivery where a tear is inevitable...I know I am leaving out some situations, but these cases an episiotomy is TOTALLY necessary.

People who say ignorant things like that about episiotomies, (people with no experience in L&D), get on my nerves because they are talking to my patients and misinforming them about childbirth, epidurals, IV pain medication and other things that they are unqualified to speak on, and I have to try to calm them and re-educate them to have an open mind about the whole delivery process. If you don't know what you're talking about don't say anything. You are NOT helping. Do you know how hard it is to fix a perineal tear? I have seen doctors pouring over a ladies crotch trying to make sure that a Mom can poop and pee out of two different holes. It takes HOURS to repair a torn ass. HOURS. Besides that, it is far easier to repair a deliberate cut than jagged edges. After I told that lady my opinion of episiotomies and challenged her knowledge base, she didn't want to talk anymore. How funny! What do you think?

DiVa...

Spring Break is over!

2008-03-30T20:39:00.002-04:00

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!

More Avoidance Behavior

2008-03-23T14:04:00.003-04:00

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!

Defending my future credentials

2008-03-22T15:54:00.002-04:00

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!

I'm gonna kill that boy...

2008-03-15T09:45:00.003-04:00

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!

It's March Already?

2008-03-08T09:42:00.002-05:00

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!

Busy, Busy, Busy....

2008-02-13T20:42:00.003-05:00

Tonight, we made red velvet cupcakes for the class Valentine's Day party. I find that cooking with kids is a great opportunity to teach a child about math and following directions. And the cupcakes are so cute. After all the baking I am supposed to be getting back into my studies. I never seem to get away from the books. Not even to spend time with the kids and the pets. I haven't even found the time to wallow in self-pity over the big break-up. That's good thing. I am so proud of myself. Maybe this time I am really ready to get on with my life. There's no maybe to it. I know I am ready to get on with my life.

I had my orientation with my practitioner clinical coordinator. I expected to meet my preceptor, but I still haven't. I need to get cracking! I got the results of the of my first test. I failed, but it wasn't because I was unprepared. It is because I am still thinking like a nurse and not like a practitioner. I get a chance to re-take the test but in the meantime, how the heck do I think like a practitioner?

DiVa...

He's Gone...for good this time!

2008-02-06T23:27:00.000-05:00

This past week has been a very busy week for me. I have been working. I am still in orientation for a few weeks. Well I should say for a few more days. Things are going well at work. I am starting to learn the flow of my shift and how to manage my patient care on DiVa terms. I am so proud of myself. But then calamity struck.

My refrigerator broke and I lost at least $200 worth of food. I have had that refrigerator since my daughter was two and here it is almost seven years later and I am buying a new refrigerator. According to the sales guy a refrigerator is supposed to last 12-15 years. It was an open box item that never really worked well but had no warranty. This time is the first time I have ever bought a brand new refrigerator that no one else has used first. It's an LG refrigerator. Here it is...
So far it is very nice. I have been trying to clean up and make the kitchen seem like a warm inviting place. There really isn't anything wrong with my stove, but since I don't want to deal with any more broke down appliances I bought a new stove too! It won't be here until later this month. It's a Maytag Gemini. Here's a photo... I have a feeling that these appliances will be cute until the bill comes...

Speaking of broken down things, my dude (my daughter's father) moved out last week. It was a spur of the moment sort of thing. I woke up Friday morning with a refrigerator full of melted and spoiling food. I came into the bedroom to wake up my dude and he said some crap like, I am not really listening to you because I am not fully awake. I thought to myself, "Ain't that some shit?" I explained to him the situation with the refrigerator and (long story short) he got smart with me and accused me of taking my frustrations out on him. So he says some crap like I don't have time to sit down and discuss the refrigerator problem because I am going to be late to work. Hmmm...would he have even been awake for work had I not come into the bedroom? Most days he arrives at work whenever he feels like it.

So then he says that the only reason why he was here in the first place was because I asked him to help out. Then I reminded him that he was doing a piss poor job of helping out. He has NO MONEY, except when he wants to buy video games, action figures or movies. When he messes up the money he expects me to fix everything. I worked overtime so I would be able to do SOME of the things that I like to do and instead of going shopping or getting a pedicure, I end up paying the bills that he was supposed to pay. I told him, he can't be faulted because I was the fool that sat up and let him do that dumb shit, but today would be a new day.

He said I am out of here. That was cool with me. I told him not to let the door hit him in the ass, but he should take care to leave my second car. I decided not to let him take the car because he is NOT going to pay for it. He was really pissed, but he tried not to show it. He said, "Is this how it is?" "So ,you are throwing down the gaunlet, huh?" He tried to make a call to his job and I said, "Oh no my brother, not on my phone." He had a lot of freakin' nerve. First he was going to stand in my floor and tell me about myself, call me out of my name, take my car and use my phone? He had lost his damn mind. In the middle of my argument with him, my sister and niece walked into my house. He said he was going across the street. I left to run some errands. While I was gone, he gathered his X-Box and movie collection and left. He will be returning for the remainder of his belongings this weekend.

Since he has been gone, I have felt so energized. I have been able to focus better on school and the kids. My family has returned as a source of support. My mother and sister have been over almost everyday. My son's father, who is generally a HUGE help just had a new baby with one of his hoodrat girlfriends. I tried to tell him that was coming. I am not bitter about the whole baby thing. I really hope that he will be able to be a part of his new son's life in ways that he could not be in our son's life. At the same time, he doesn't need to expect me to help him financially support this kid. He better not short my baby, either. The positive to all this is that I am getting better with my confidence level and that my children are learning to contribute to the maintenance and upkeep of our home. For the first time in a long time, I feel like everything is going to be okay.

DiVa...walking the walk and talking the talk of a empowered woman!

What I love most about blogging...

2008-01-31T22:45:00.000-05:00

Is that I can come here and be as insecure as I want to without the worry of my competency as a nurse being called into question. Today was my first marginally rough day at work. I think what is happening is that my feelings from my old job are complicating my ability to focus on my new job as I should. I am worried that I am not learning the new job fast enough and that my hesitancy in being viewed as an inability to do the job. Then there is learning all of the paperwork, personalities, physicians, protocols, passwords, preferences, practitioners, pumps and pregnant patients...all of which is making me dizzy. Plus I am tired as hell and behind on my class work, but that is another blog entry.

Okay so I was in a delivery and my baby came out floppy. For one, this institution doesn't seem to freak out about anything. The baby nurse just casually came over and rubbed the baby's back. The midwife handed me the bulb syringe and I started helping with baby resuscitation. The worst thing of all was that I was in the way, and not very effective at prioritizing my interventions. I was a little embarrassed, but it was a defense mechanism from my county days. I was never allowed to participate in my own baby code situations. I was pushed aside, instead of being guided. Those neonate resuscitation classes are great, but it is a totally different ball game when you have a human, blue, floppy infant on your table. I was previously precepted by a maniac that freaked out over everything…to the extreme.

My preceptor reminded me that I am not the baby nurse and that I needed to focus all my attention on taking care of Mom. I just wanted to be everywhere at once. Then it was the end of my shift and I wanted to stay and finish the delivery, but my preceptor sent me home. She was totally nice. It wasn't at all hostile. She did mention that I know what I am doing, but I need to present myself in a more confident way or I will have problems with some of the other nurses who have a strong personality. Here we go again...

I have to learn to put on a better game face. I must come across as unsure of myself. I think it would be really hard to be walking around like "Nurse-know-it-all" but at the same time I guess I can't be looking for approval for the things that I do. Maybe I should re-think my idea to work and go to school. I was warned, but then once someone tells me that I can't do something, I feel a subconscious need to prove them wrong. I think I'll be alright. Pray for me...

DiVa...I am not giving up on this job, especially since I saw my first check!

Close Encounters of the Roach-kind...

2008-01-24T23:55:00.000-05:00

It seems like lately,roaches have been making their presence known. Not in my house. My house isn't as clean as I would like it to be but no roaches. An occasional ant or flea weather permitting, no roaches. Ever. I have heard of people seeing roaches at establishments. For instance, I was in my theory class the other week and the cafeteria at the school was closed. So everyone went to the hospital across the street to get breakfast. The dude in front of me said his friend stepped up to the counter and the cook asked her what she wanted. She told the cook, "I want two pieces of french toast, two pieces of bacon. By the way there is a roach on the counter behind you crawling on a Styrofoam cup." According to the dude, the cook kept on cooking and the roach lived to see another day. I guess she figured that the roach wasn't hurting anything. Either that or the cafeteria doesn't pay her enough to cook and kill roaches!

That story reminded me of when I took my daughter to get her hair done. This is a process that takes hours. So she asked me to get her something to eat. She took a break to eat her food and I closed the bag and set it on the table in the shop. When the stylists reached the two hour mark, my daughter decided that she wanted to finish her sandwich. She opened the bag and I heard her shriek. I was like, "What is wrong with you?" She said, "Mom, there are beetles on my food." I knew instantly that she was talking about roaches. I picked up her bag, tiny roaches still crawling out and threw it in the garbage. Then, as they were finishing her hair, I saw a HUGE roach crawling across the floor. I wasn't the only one, my daughter saw it too and started to cry. The stylist took a cup of boiling hot water and poured it on the roach and then asked me, "Is it still moving?" I would imagine not. Next time we will have to get to the shop before nightfall.

Last week, my FOB came home and said, "You look tired, let's go out to dinner." I was like, "Hell yeah, I don't feel like cooking anyway!" So me, him and the kids all piled into the car and we went to the Chinese buffet. We were all walking around putting our plates together and I decided that I wanted to try the hot and sour soup. A friend of mine had me try some of hers and I thought it was pretty good. I walked around the buffet table and grabbed a little saucer when something shiny caught the corner of my eye. It was a HUGE roach walking right towards the hot and sour soup. At first I was like feeling sorry for the roach and decided I wasn't going to kill it. After all, it wasn't MY house. But then I thought, what if someone else EATS this roach after it fell into the soup. Eww! I grabbed one of the saucers and killed the roach. The guts were smeared all over the underside of the plate. I called my FOB over and said, "I think we should probably leave." He said, "I ain't paying for this shit, that's nasty!" I agreed, then I called one of the servers over to the buffet table.

I showed her the roach and she picked it up with her BARE HAND and rubbed it between her thumb and index finger to be sure it was dead. She was like, okay and she took it back into the kitchen. I don't know what she did with the roach but our family left that restaurant. There was a lady sitting at another table. She was finishing her food and paying her bill. She wanted to know sooo bad why we were leaving when we had only been there for about five minutes. There was a guy at the buffet table the same time I was explaining to the server. I don't know if he left too, but damn that's nasty. The server tried to act at first like I planted the roach on the table, but I told her to review the roach guts on the underside of the saucer. She couldn't say ANYTHING after that. We walked out and went to another restaurant. My eyes were peeled the whole time. I was kinda freaked out because the carpet was brown. The design had me thinking that there were roaches everywhere, even though there were none. Basically, my appetite was ruined.

The scariest encounter I had with roaches was probably the night at the county hospital. I had a busy night and the shift was over. I had to go the bathroom really bad and I had already left the floor. I was in the basement. The nearest bathroom was the janitorial locker room. I opened the door and ran in. All of the toilets were filled with this putrid blackish brown water. I turned around and notice a field of dead roaches all around me, lying on there backs and all dried out. I was in such a hurry, I didn't even notice. There were hundreds of roaches everywhere. I ran out of the bathroom. I didn't have to go to the bathroom anymore. I rode home the whole 45 minutes and went to the bathroom in my own home.

How the Hell do these public places stay in business with roaches like that?

DiVa...grossed out with all this roach talk!

New Job, New Semester

2008-01-23T11:04:00.001-05:00

A New Job

My new job is cool! Luckily, my training manager didn't tell Nurse Evil that I didn't want to be precepted by her. I could see immediately why she might have had a problem at the county. She runs her mouth constantly, is a bit of a gossip hound but is a very skilled nurse. The whole precepting thing is going much smoother having an basic understanding of labor and delivery. I guess I need to understand what they do when emergent things happen. For example, if I had a patient with a fetal heart rate in the 60's at the county, we would watch the first brady and doing the basic interventions. By the second brady we would be pulling the bed out of the wall and running to the Operating Room. By the third brady we would be getting ready to cut. At this institution, they wait to see if it comes up. If it does, they continue as usual. If it doesn't, they check to see if the Mom is ready to push. If she is, they try to deliver a baby and call code pink.

This new relaxed way of looking at a tracing is foreign to me. If I just turned the patient and put on O2 with the first late deceleration and only called the doctor on the second late, I would be in huge trouble. Huge. They would be talking about me in the break room and the doctors and nurses would not trust me to watch a patient. Seriously. The county was a hostile work environment. Not here, at least not yet. They only come if you call for help. I appreciate that. And when they do come, it is not in the spirit of making you feel inept, it is truly to help. This time, I am adjusting my attitude. I am approaching this job as a skilled, experienced nurse. I am confident in the things that I know. I am not going to have a negative outlook, I am going to leave my past behind me and look forward to the learning opportunities that exist. Besides, I am only going to be there three days a month. I believe I can do it.

A New Semester

This past week I had more intensive courses. I am taking classes to prepare me to be a clinician. This is where I am not as confident. When we were learning about how to prescribe insulin it hit me that I am going to be responsible for diagnosing and managing patients with chronic health conditions. What if I prescribe a medication and my patient gets hypoglycemic and has to be hospitalized. Scary thought! I know that I will be supervised in the beginning and I will not be turned out into the wide world of medicine without passing a certification but it is still a bit daunting.

This semester I am taking advanced pharmacology, my clinical course and theory (boring). I am supposed to be working on a paper. This week and next week are going to be devoted to getting that together. I am already a little bit behind on my reading. In my clinical course, they don't assign chapters, only subjects and it is your responsibility to read the chapters that pertain to that particular subject. We had our first quiz. This particular quiz they gave us a patient's information, demographics, symptoms etc. and then we had to organize and prioritize the information, develop a differential diagnosis (what you think they have), develop a real diagnosis, a plan of care and then follow-up. All of this using no resources. No books, no medication guides, nothing but your mental mind. I don't think I did too bad. Clinicals at this point are at a standstill. My preceptor is on vacation until February which means I will be going to clinical almost everyday.

Well, I should try to get back to work. The kids will be here in a few hours bugging the heck out of me!

DiVa...suffers from study inertia

Will I ever have a life...again?

2008-01-16T21:10:00.000-05:00

I am so crazy. By the time I finish this doctorate, I will have spent a total of almost seven continuous years in school. And now I've added a job to the equation, what quality of life will I have? What made me think I would be able to do graduate school full-time and work three days a month and do 20 hours of clinical a week and have clean clothes for three people and prepare home-cooked meals and mother my children and maintain a sane mind all at the same time? I mean it can be done, but I don't know if I am the DiVa to do it. I manage to keep a smile on my face and a bounce in my step but damn, damn, damn am I tired.

Between pharm class, clinical, my theory paper and Adult health lecture one question remains...Will I have time to watch American Idol? It is my comic relief, until the real competition starts. I absolutely HAVE to make time for American Idol. It will probably be the only thing that I get to do that is unrelated to nursing, besides my regular activities of daily living.

I bought myself a PDA as a Christmas gift. At first I thought it was a total waste of money. It was on sale for $199 and I thought what the heck, why not? I am so glad I did because all of my classes and clinical require it, mainly for Epocrates. I'll have to keep you posted on whether or not it was a worthwhile purchase. It seems that every APN I've run into this semester says they don't know how they ever made it without a PDA. We'll see...

Well, got to get ready for the old am routine. As far as my resolutions go I have been pretty close to on target. I am planning to start the flylady thing in February.

DiVa...Has an 11pm bedtime but my inner perfectionist won't let me go to bed without everything done!

I need to silence my inner idiot!

2008-01-15T19:24:00.001-05:00

When I worked at the county, I heard many a tall tale. Well I don't know if they were all tales, I imagine some of the stories were true. I have always thought that if more than four people tell the same story, then the story is true. Most of what I was told were a first person accounts so I doubt that what I was told was a rumor. Anyways there was legend of Nurse Evil that circulated on our floor. She was the most cruel of labor and delivery nurses as the story goes. She ate new nurses alive and people shuddered in her wake. She had an entourage. The three nurse team was called "The Trifecta" and when all three of them worked the floor, anyone who was not in the good graces of "The Trifecta" would call in sick. It was because of "The Trifecta" that everyone began the ritual of printing the entire schedule instead of only printing the page that pertains to your hours worked. I only know of this because one of the members of "The Trifecta" told me about it. She wasn't proud because being a member of this elite group almost cost her her job and she didn't want me to report her for being nasty. I digress...

Nurse Evil left just a week before I started and I was told that if she knew me, she would ridicule me because of my unique appearance and sense of style. There was a nurse that worked on the floor that wore her hair in a style that Nurse Evil didn't like and she was able to convince those in her favor to wear a cartoon character sticker on their lab jacket that was supposed to represent this particular nurse's style, (or lack thereof). They said she was insensitive to the patients that were too needy, poor or just plain uneducated and discourteous to their families. Nurse Evil was only PRN, which was surprising. I guess not too surprising since PRN means that you can work whenever you'd like. Nurse Evil sealed her own fate when she was a no call no show, or something like that. It was rumored that she tried to get her job back but the management would never allow it because she created such a hostile work environment.

I have found that working in labor and delivery, it is a small community. There are only so many places you can work before you run into someone, somewhere that knows someone who knows you. I happened to be in the lunchroom and began to ask me if I knew random people from the county. I knew them all, and to my terror I did not know the nurse personally, I only knew of her legend. It was Nurse Evil. Shit! How bad can it be? I work PRN, what are the odds that I would run into Nurse Evil? I received my preceptor assignment for the week and who is my preceptor? Nurse Evil. She was assigned to be my preceptor for a whole freakin' week and I politely asked that it be changed. After I said it, I immediately wanted to take it back. It was risky, but my inner idiot wouldn't let me be quiet. I thought of all the times that I had bad experiences in training and I wanted nothing to distract me from learning. The legend preceded her and there is no way that I would not have been second guessing myself the entire week and she would have said something out of the way and I probably would have quit right on the spot.

But then I thought about it some more and I realized how immature and silly I am. I am judging a person based on unsubstantiated gossip. I never even met her and I let a story scare me into missing out on a potentially rich learning opportunity. This makes me just as bad as the people who kept the legend going. Nurse Evil, I am issuing you an apology. What if she has changed? Or found God? I work three days a month for crying out loud! What if the manager of training goes back and tells her that I requested another preceptor? She asked me why and I told her that I knew of Nurse Evil from my previous job and that one of my colleagues had a negative experience with her while in training. I went on to say that I felt I would be distracted from from learning the job properly. I think my reasons have merit and at least I didn't repeat the WHOLE legend. Ahh screw it, it's better to be safe than sorry, and besides if I had agreed to be trained by Nurse Evil and it was going bad, I would have been stuck for the whole week. Whatever, it's done now. I should be glad, that is if they could find someone else to train me. I don't know if I have escaped the gauntlet. I need to grow the hell up...

DiVa...I can do ANYTHING three days a month!

Like riding a bike!

2008-01-14T19:24:00.000-05:00

Being a nurse is like riding a bike. You never forget how to do it, once it has been ingrained into every fiber of your being. This L & D unit is okay. I won't get too excited because it is only my first day. All the rules seem to be relatively the same, except the charting system is a pain in the butt. Otherwise, this hospital is labor and delivery utopia. The rooms are very nice and clean. I was so comfortable, it was hard not to jump in and get started. I think I want to take my time and really make sure I know my job before they turn me loose on my own. I can tell already that they trust me. Being in this environment really has me questioning my choice of clinical focus. Am I really a family practice nurse? Or a midwife? I will probably end up being both.

I can tell already that there are a few bitches that I am just not gonna like. That's a shame. I have already decided that I am not going to get caught up in the office drama. Besides, I only have to work 2-3 days a months and I have too many other things to worry about. I am focused on what I need to do for a change. Also, the clientele seems to be dramatically different. More affluent people than at the county. I will certainly miss that as well. I am excited to get back into the clinical area. I just wonder how I will balance work, school and motherhood...

Tomorrow is my first day of school. I am planning to start clinical in three weeks. The FOB is going to help out until February. Things are slowly falling into place. The house is starting to look like it is inhabited by human beings again. I am nervous about being on my own, especially since my baby sister asked me to keep my five year old niece for a few weeks until she can get herself together. This is a luxury that I have never been afforded when I was a young mother trying to figure out some direction in my life. I have no idea who is going to watch her while I go to school and work. I am still trying to figure out what I am doing with my kids after school certain days of the week. Today I was caught up in a delivery and I couldn't leave on time and my son was stuck at bowling practice with no ride home. I know there will be more days like this. I am thinking about having my brother help out. We'll have to see what he says.

Well, gotta get ready for tomorrow. Just thought I'd stop and make a few notes. I am happy for the most part and I can't wait to see what class will be like tomorrow.

DiVa...finding ways to keep myself busy, unintentionally!

The one that got away...

2008-01-04T21:38:00.000-05:00

There is a resolution that I should have added..."Be on time, DiVa!"

I cannot be on time. It doesn't seem to matter how early I wake up, if I lay my clothes out the night before, Hell, if I slept in the car I would STILL be late! Why can't I make it anywhere on time? I am late to school. I want to be on time, but I live 45 minutes away from school. My kids have to be at school by 8am and most of my classes start at 9am. If I run into a traffic jam on the way to the University, I am definitely going to be late which is totally beyond my control. My family knows that if they are waiting for me to show up somewhere, I will be there 1/2 hour later than the time I am supposed to be there. Will I like it when I am a clinician and my patients are late? Or a professor and my students are late? Probably not. I am really going to have to work a bit harder to be on time. I am so inconsiderate of others. (This is a HUGE area of opportunity for me.)

And as of late I can't sleep. I am tired, but I can't sleep at night. During class is when I get sleepy. That is so BAD! I really need to get my shit together because it is such an insult to my instructor to be sitting in class nodding. Usually it is after lunch break that this phenomenon occurs. I even tried to stand up because I could not stay alert. Then I thought maybe if I participated in class I would do better with the awake thing, but I can't even put my thoughts together properly because my mind is tired. I guess one could say that as much tuition costs for a graduate program, it is an insult to me that the course content should be engaging to say the least. But in saying that I am justifying my inability to stay awake, which is RUDE! I am going to be a teacher one day. I will want to KILL someone for falling asleep in my class, especially if I spent time and effort putting together materials. Tonight I am going to make my best effort to get to bed at least by 11pm. (Not so worried about this issue as I think it is situational.)

As far as school goes, all of my books have arrived. Next semester is gonna be GREAT, however, this intensive class is kicking my butt a little, (nothing like the Advanced Physiology). We are cramming a 12 week class into 5 days. My mind is still on Christmas break. This is a class on nursing research and nursing theories. Very dry content. I am currently developing a paper and a group presentation, both of which I need to get started on soon. Our theorist is one of the hardest to find current research development on. The theory is so complete that no one can add anything to it to expand the research. We cannot find any current journals articles that reviews or revises the theory. In a way that is a compliment to the body of work. Not good for the presentation though. And the research area is so narrow, it will be a challenge to apply the theory to nursing practice. But the DiVa will make it happen. It's what I do...

At least I don't have this sinus infection draining all of my energy anymore. Breathing through the nose is an underrated experience! Now that I can breathe through my nose it is like all of my creative energy has been restored.

Well, might as well get started on the projects.

Ta-ta for now!

DiVa...Gonna get herself together for the last few days of her intensive!

Happy New Year!

2008-01-01T23:45:00.000-05:00

I have been sick for the past day or so. Luckily, I let the kids spend the holidays with the in laws and I spent New Years Eve alone. Well, not really, the resident jerk was here, but since I was sick, he has been keeping his distance. Not that he even cared to begin with. I asked him to take the dog out and run to the grocery store and get me my favorite sinus remedy and he actually stomped his feet and sulk like a huge baby! It was amazing to see a grown ass man throw a tantrum about doing what he should be doing anyway...

I feel a little better now, and I have no choice but to get my butt in gear because I have to be back to school tomorrow. I ordered my $400 worth of books and have proceeded to get my crap together for clinical. I have also planned my days down to the hour. I turned the leftover turkey into Turkey noodle soup. No laundry yet though. I still need to make arrangements for my children. I found an after school bowling program for them, that's one day a week down, at least 4 more to go! I am a work in progress...

So now on to my New Year's resolutions.

I have 10 things that I resolve to do in the coming year.

1. Love DiVa to the fullest, no matter what the year may bring!
I think self-love is at the core of all my insecurities. If I love DiVa, everything else will fall into place. That means making time for my manicures, pedicures, hair appointments and date night! Not with a man, just me the bubble bath and relaxing music.

2. Lose Weight
My goal was 30 pounds a year, but my personal trainer told me that was not aggressive enough. Even though she is a crazy biotch, I love her and I hope that we get the opportunity to work together again. Diet and exercise will become my best friend. At 5am every day I will attempt to be at the gym. And I am seriously going to have to get my self started on the Beck Diet Solution and Dash Eating Plan. I should be at least 20 pounds lighter before swimsuit season. If I can only find the time...

3. Set Boundaries
This is another thing that is the very essence of my problems. If I set boundaries I will be able to lose weight. That goes for my relationships too! The kids, my ex-dude, friends and family, most importantly my mother. I love her to death, but she is going to give me a freakin' break for crying out loud! I have already started by ignoring the phone calls from my crazy cousin. Do you know she has reduced herself to using the kids to work on me?

4. Get Organized
I tried to get the house together over break. I found this person on the net called the FlyLady (http://www.flylady.net/index.asp). I have been threatening to start her program for almost 2 years now. This is something I really want to make time to do. She guarantees that your house will be presentable to company within 30 days. You begin with shining your sink and move up from there. I will let you know how this works out!

5. Stay Focused
I have a tendency to get off track. I once talked to my advisor about problems I was having at the beginning of the semester. She told me that there are things I have time for and things I don't have time for. She went on to say that right now the two most important things in my life right now are my kids and finishing my doctorate. I am going to put that on my motivational sticky notes.

6. Be a Better Mom
I don't think I am a bad mother, but I do need to set some boundaries, clean up my kids diet and set a better example. They need a decent bedtime, healthy meals and snacks and some serious home training. They need chores and someone to spend some time teaching them the facts of life. And that someone is me!

7. No More Fast Food
This one is going to be really hard because it is much easier to stop at McDonald's and pick up some .99 double cheeseburgers than it is to make a real dinner. I am really motivated to making this resolve stick. For the sake of my health and the health of my children.

8. Quit Smoking FOREVER
Alright. I will be honest. Occasionally, I like to have a cigarette. I like smoking. There, I said it. I know it is bad for me, smoking has been banned inside bars and restaurants, it should be simple...right? WRONG! When I feel stressed out, I want a cigarette so bad it kills me. I have been able to hide my little smoking habit from my children. I have stopped buying my own cigarettes, I just smoke my sisters or my friends. I really want to quit for good. I don't want Cancer or COPD. Now I need to JUST SAY NO!

9. Get back to church
When I was going through my valley phase of life I felt like God had abandoned me. I thought, if God really loved me like they say He does I would not have all this suffering. It is my belief that all of the suffering that I have endured has been for a bigger purpose. Maybe, it is a blessing and something I have gone through will help someone else. I know for sure that I have been blessed because I have everything I need and then some. I want to give back. More importantly, my children need to have a religious foundation. I am embarrassed at the fact that they know nothing about religion.

10. Balance all that stuff
I was talking to my personal trainer after she sort-of fired me. I won't say she truly fired me, I just had a lot of at home catastrophe at the time (broken fridge, bad grades, broken heart...etc.) and she wanted me to resolve some of my at home stuff and resume training at a later time. Now, I was supposed to be continuing to go to the gym every Tuesday, Thursday and Saturday. I haven't been going because school had just gotten out of control and I needed to get things back in control. After I missed the first day or two she called me, and I explained what was going on. She told me not to let school take over, and of course I did. But this must not happen anymore. When I was working on my undergrad, I didn't watch TV, do anything not related to school. I didn't even visit family or friends. This can no longer happen. Life is too short, and I wanna have some fun!

DiVa...Have a Great '08!

Momma needs a break...

2007-12-31T08:01:00.000-05:00

Over the holidays, I had my nieces and my kids at the house. My nieces were sick as hell and now who has an itchy throat just in time to go back to school? Yeah, it's me. Today I am awake early. During this whole break from school I have been either cleaning this house or entertaining children. I am about to get my ass out of bed and make a pot of chocolate velvet coffee. Then I have to go downtown to get my children's birth certificates, (why couldn't I have birthed my children in the suburbs?), after that I guess I will visit some people provided that I still feel well. My kids have been so bored. So I guess I'll let them spend the holiday with the in-laws.

DiVa...Time to get motivated!

Seasons Greetings!

2007-12-27T13:33:00.000-05:00

Xmas has been crazy at my house. The kids were happy with their gifts and I enjoyed my family but I am tired as hell! They were all at my 712 square foot house. Since I don't have the opportunity to clean my house when school is in session, I try to clean my house during breaks. Mind you, my house hasn't been seriously cleaned since 2004 so there are still alot of things that need to be done. Cabinets and closets need to be cleaned, drawers need to be organized. Oh and we can't forget that my daughter's father is getting ready to move out for good! Yes, the administrative decision has been passed down and that no good bastard is supposed to be leaving on January 19th. That works out just fine because my last intensive course is on January 19th. I am debating on whether or not I will allow him to take a vehicle with him. I am leaning towards no because I don't feel like dealing with the drama that ensues when he misses a payment.

I am trying to figure out some arrangements for my children. I know that I won't have coverage for my children either before school or after school. Hell maybe even before and after school! So I plan on getting each one of them cell phones. I will get them ready for school and leave for clinical. Then when it is time for each of them to leave, I will call them on their respective cell phones and give them directions. I might even set their book bags on the front porch the night before so they don't forget them. They will both need house keys. I got a crock pot for Christmas so dinner is out of the way. I also have a coffeemaker coming so I can make plenty of Cuban Coffee! I've been told that anything is possible with Cafe Cubano so I am going to try it out. I am planning to start my new job soon. I am almost excited at the challenge of being able to do this on my own. It has become clearer with each passing day that my live-in jackass has been no help at all.

He threw away the kids birth certificates. Now I have to go downtown and get another copy which will cost me at least $40. I don't have the money to buy new birth certificates, but not only do I need that, I need a copy of their social security cards and shot records. I could kill him. You can't trust a man to clean. I know that now. I unpacked box after box of worthless papers and sales ads mixed with my important papers, shoes, crayons, toys and used tissues. It took almost a week to get things somewhat organized and I am still not even close to done. My downstairs is filled with laundry. I feel like just throwing the clothes away and starting all over. I asked this idiot to clean one room. It was clear that he really didn't care to clean up at all and he did a piss poor job. He has lost all respect for me.

He overflowed the toilet and left the mess in the bathroom for me to clean. But to his surprise, I told him to get in there and clean that mess up. He knew he was wrong and it wasn't the first time. One day he threw up and left it. I told him to clean it because he would never leave vomit on the floor for his mother to clean. He tried to act like it was just a little food on the floor. He knew better, and I know Ms. Linda raised him better than that, of course then again I don't know...? He cooked meals in my kitchen and refused to clean up after himself. I wish he would leave now. I can't even look at him without wanting to kill him. If he continues to not take his medication as prescribed he will certainly die on his own. He has been complaining of the worst headache of his life lately. He says he only takes his medication during the week as it saves him on refills. I won't bother to reiterate the concept of rebound hypertension, (he thinks I sent in box tops for my nursing degree). I took him to the hospital the first time, the next time, when I find his collapsed body in the floor I'll call the ambulance.

Aww, enough about that jerk. I am really happy about the changes that have happened in my life this past year. I conquered a job, was awarded a fellowship, conquered a few courses and regained control of my household. No small feat if I do say so myself. I will return in a few days to plot out goals for next year. Next stop, 2008!

DiVa...Trying not to choke this house full of kids undoing all my hard work!

One semester down, many to go...

2007-12-14T01:42:00.000-05:00

It is the end of the semester I never imagined that I would get through it but I did. I took my last final on Wednesday. I got my first "A" in physiology. I ended up with a "C" in physio as my final grade and I was only 2 percentage points away from a "B" as an overall grade. Impressive considering that I started out the semester with a 63%! I got A's in all of my remaining classes. Overall, I ended the semester with a 3.11 GPA. Amazing! I am well on my way to being Dr. DiVa...

Today we went out to eat and came home to find the front door standing wide open. Luckily, all of our belongings were still here. Before we left the house, I asked if the front door had been secured. I was assured that it was locked by my daughter. What I found out later was that after she had locked the door, but my son took the dog out for a walk and hadn't closed the door all the way. She took responsibility for the whole incident. The bastard (my fob) went ape shit! He got out of the car and ran around to the front door and went into the house looking for an intruder. He proceeded to walk around the house yelling like a crazy man. It was almost scary!

My daughter, my son and I unlocked the back door and entered the house. When we got in the house, the FOB laid into my 8 year old daughter and she threw herself across my bed sobbing uncontrollably. I asked him to speak to her calmly and he refused, claiming that she deserved to be yelled at and that he needed to make sure that no one was hiding in the house. Praise be to God, nothing was missing and no one was in the house waiting to kill us. I sat the kids down explaining to them the importance of making sure the door is locked before we leave. I went on to tell them that while I would have been upset if our nice things had been stolen, the nice things that we have are only material things. The most valuable thing that we have is each other because everything else can be replaced. My daughter is still crushed and her has father still said nothing. He is such an asshole. He had no right to be mad at her because he was the last person out of the house. He was the one that refused to go back and check the front door.

He is also the reason that our toilet had to be replaced this week. If he had repaired the bathroom door properly the first time, the door knob never would have fallen off and into the flushing toilet where it obstructed our sewer system. If he had paid the car note like he was supposed to, it never would have been behind and we never would have had to try and refinance the loan so we wouldn't have to pay three car notes at once. I wish he would go ahead and leave now because when I remember how I got played I want him to have a stroke. I probably won't have to wish that because he hasn't been taking his medication and he still hasn't had that tumor checked. I can't understand how a man could be so thoughtless. As my advisor said the first time I talked to her about my problems at home, I don't have time to worry about his insecurities. I am busy as hell trying to become Dr. DiVa.

I had to quit seeing my personal trainer, mainly because my refrigerator broke and I had no way to store food. And since the moratorium of fast food is part of my plan to get healthy, she said that I should use my money to get the refrigerator fixed and resume personal training when I got everything straightened out at home. I miss working out. I was supposed to continue working out on my own, but without my commitment to meet with her, I felt no obligation to do so. I got so busy with school there was just no time. Then there were finals. Unfortunately, fitness is not something that can wait until I am finished with school. So I have to make time somehow...or pay her to police me!

I talked to my best friend from high school today and she told me that she had a miscarriage. I realized that I too am getting older and there may be a very real possibility that I may never have any more children. I mean, I don't think that I want to have a baby at this moment because I am in over my head and in a loveless relationship, but someday I think I'd like to have a baby with a man who loves me and is excited about having a family. I shouldn't give a damn about another baby. I don't understand why this is something that bothers me, but it is bugging the hell out of me. If I focus on school, everything will fall into place I'm sure.

Next semester I start clinical. This is so exciting. I washed my lab coat but I need to wash it again and iron it so that it will be crisp for my first day of clinical. I bought a PDA so I wouldn't have to carry 101 reference books to clinical. The only thing I have left to do is get my books, purchase health insurance, call in the results of my TB test and get ready to start my new job. I am going to be so busy, I really won't have time for the jerk in my house.

DiVa...still impressed over how I turned the semester around!

Thank Jesus they're gone!

2007-11-18T15:39:00.001-05:00

This morning I woke up with her standing over me. It was 0647 and my alarm was ringing. She said, "Your alarm clock has been going off for about 10 minutes." I said, "It has only been 2 minutes...tops." (This was not intentional. I wake up at that time to get the kids ready for school.) I turned off the alarm and laid in bed for about 10 or so minutes thinking of a way to get this bitch out of my house without having to fight her. She must have known that her welcome was worn out. I hear my cordless phone dialing. Yes, she is making plans. I got up to go the bathroom and then sat at my little bistro table. I asked her what her plans were for the day. She and I talked about miscellaneous things for about an hour. Mainly, she was crying about having to spend the night in jail because she was out at Kmart shoplifting and got caught. She missed her court date for the incident and her nephew was trying to make sure that bench warrant was activated. If you can't do the time, don't do the crime!

Then at around 8am I say something clever like, "Look, today I need my house to myself. I have studying to do and I need to prepare my household for the coming week. I cannot watch your children and do all the things I need to do. Furthermore, I am not working right now and I cannot afford to feed your children. I have no gas in my car and next week is Thanksgiving. You need to be out at minimum by noon. You may use the phone to make any arrangements that you need to make and I am willing to drop you off where ever you need to go, but you and the kids need to go, TODAY." Like clockwork, this bitch woke up her children, combed her daughter's hair (which looked like a treasure troll), put her wig on and was ready to go by 0830. This bitch had somewhere else to go the whole time. I feel like such a gump. Here I was trying to help her get her shit together, find a new place since she got evicted, etc...and she could have BEEN gone.

I watched every one of those kids get ready to leave, making sure that they took only what was theirs. They all piled into the car and I took them to the projects, where she wanted to be dropped off. She walked up to the buzzer, rang once and then motioned for her kids. They all piled out of my car. They said thank you and goodbye like they were truly grateful. I peeled out of the parking lot and returned home to see my son sleeping peacefully in my bed. I go to the kids room and it smells like "stinky vagina" in there, and the weird thing is that there were only boys in the room. I stripped their beds, washed down the walls and laundered their bed linen. I scrubbed the bathroom down too because it was smelling like "open ass" even with no one in there. Thank God I only used plastic utensils, plates and bowls. I threw all that stuff away. It still feels funky in here. I don't think I'll miss them at all. I certainly won't miss the smell of her wine black & milds in the morning. She just called to ask about some of the houses we looked at this weekend. (Cringe!) I hope she leaves me alone for a while.

DiVa...Must learn how to set boundaries.

By the way, I lost 6 pounds last week. I can't believe it and my personal trainer is the BOMB!

Why is this heffa in my house?

2007-11-17T19:58:00.000-05:00

Friday afternoon, there was a knock at my door. It was one of my cousin's six kids. She says, "My mother wants to know if she can come in and talk to you." I say yes. Why did I do that? It was a trick. I am in the middle of her dumb ass drama yet again. Her visit was with purpose. First she pretended like she wanted to know why I cut her and her side of the family off. Her brother and sister hustled me for $40 because she was in jail for some "unknown" reason. Unbeknownst to me, my uncle wired her bond money. So whatever they got from unsuspecting donors (such as myself) was all profit. This was no surprise to me because I had a feeling that something was fishy. Never again.

So basically, the situation going on right now is that her nephew (20 years old) had no where to live. His own father wouldn't let him stay with him, so my cousin brought him into her home. She let him stay there, and put her car in his name since it wouldn't pass the emissions test for our state. He (the nephew) got mad because he didn't like the dude she (my cousin) was dating and threatened to cause bodily harm. My cousin feels like she can date who she wants to and so she asked him (the nephew) to leave. As it turns out, her trouble that she needed bond money for is unresolved, thus she has a warrant for her arrest. Since she asked him to leave he has been fighting her children and he calls the police to come and pick my cousin up every time she goes home. And the cops are so stupid, they actually show up!

What does all this have to do with me? They had no where to stay and so she asked if she could crash at my place for one night until she could get into a battered women's shelter. I suggested a battered women's shelter because I didn't want to see her in jail for the weekend and I didn't want to be responsible for her kids. She really didn't want to go to the battered women's shelter. One day has turned into two. My house is 712 square feet and I have 10 people here. They have got to go. I have a life and responsibilities. I have been feeding them, washing their clothes, cleaning up after them...my daughter said the hell with this called her Dad and left. My son just got off the phone with his Dad. I wanna go somewhere too! I have my own problems such as school, finances, etc... I am dealing with my problems and I am not trying to hook other people into my drama. This is what I get for trying to be nice.

There are five kids in my house. The one that is 14 years old and weighs 400 pounds clogged up my toilet and wet the floor so bad that my basement ceiling was leaking.(I can only imagine what kind of TURD that was!) He was standing there like a dumb ass watching the toilet overflow! The 5 year old whines and whines and whines. I want to beat that kid so bad! The 8 year old is and animal lover (think Elmira from tiny toon adventures). My animals stay in hiding when she comes around. This is the goofiest 8 year old ever as she is constantly getting into things. All I hear is KaBoom, KaBoom, KaBoom when she is in the living room by herself. The 13 year old is on the computer doing God knows what til all hours of the night but she isn't bothering me...except when I thought I heard her asking about downloading something. I just had to completely erase my laptop and reformat it because of a virus or something and I did the same thing a few years ago with the desktop. When I said something, she had the nerve to get smart! The 10 year old is hard-headed. He is constantly walking around and walking around. He just annoys me in general.

They all stayed up until almost 4am last night and then they woke up early as hell. They all get into things. They are all bored as hell in my house. So then they break things, yes even the 14 year old. I wanted to listen to my physiology lectures, but then she (the heffa) asked me if she could help me. I told her to control her damn kids. I am putting my foot down, tomorrow she absolutely has to leave. I can't take their shit any more! One of 'em gots jokes. The 400 pound one said he clogged the toilet again, that's it...they gotta go first thing tomorrow morning. They don't even get breakfast!

DiVa...about ready to call the damn police herself and drop the kids off to the crazy azz nephew. (Or the transvestite uncle!)

Be careful with oven cleaner!

2007-11-14T00:03:00.000-05:00

I was cleaning my oven today and gave myself a chemical burn. I read the directions on the can and thought, I could probably do it without gloves. I was wringing out my dishrag and noticed that my arm was itching and tingling a bit. I looked at my arm and noticed that I had a couple little blisters. I was like "shit!" I washed my arms with dishwashing liquid. I don't even remember getting it on my arm. I was able to stop the advancement of the burn, but I still have a few dots of second degree burns. I hadn't realized that oven cleaner was that caustic!

Welcome to Graduate School
My narrow escape of Academic Probation

School is going much better. I have been doing assignment after assignment and am exhausted. Last week was probably the busiest week of all. I have turned my physiology grade around tremendously. To my amazement, I might have the chance to get a "B" and at this point I would have to get a 54% on the final to fail. That doesn't mean I am going to relax. The final covers three to four different subjects. Preparation for the test requires me to spend at least 12 hours a week outside of the four hour lecture. So that's like a total of 16+ hours.

Then I had a huge presentation that I had to do for my health promotion class. I had to talk to adolescent boys about puberty. I was a little nervous talking about erections and such, so at the last minute I changed my presentation to discuss all changes except reproduction. The boys were pretty attentive during my presentation. And their questions were pretty good ones. For the most part. I hadn't anticipated that the boys were so concerned about nutrition and flatulence. I would have included more information. This health promotion class is probably one of the BEST classes I have taken this semester. The assignments required us to assess our own health habits. I am very lazy and I have an awful diet. I decided to make some changes. I am now on a diet and have hired a personal trainer.

What's up with me...

This personal trainer is pretty good and affordable. She's a little cooky, but I like her. She has spent alot of time helping me get my crap together, I never realized that I was so un-together. At first she wanted me to follow the Beck Diet Solution. But after talking to me and assessing my current living situation, she realized that I am not ready for the Beck Diet. I have to resolve the chaos in my house before I can resolve the chaos in my body. So we meet twice a week at 5am for exercise and counseling. And then one day a week I work out independently on exercise equipment that she can monitor my progress. I would say that she is more of a life coach than a personal trainer. In a way I feel like she is mothering me. It is cool, I need the discipline. I want to stop the chaos in my life.

So we work out and talk about my housekeeping, my eating habits, my defunct love-life and my children. With each work-out, there is a housekeeping assignment. For example, this past Saturday, we worked on the kitchen. I worked out on the equipment and then went home and cleaned out the refrigerator. Then my assignment for Sunday was to re-arrange my cabinets and wash all the dishes. Today, I worked out in the pool and cleaned my stove. I love it. She is helping me to find order. Another big task is to eliminate fast food. I really like fast food, and it is convenient. But I have a goal to lose a huge amount of weight. At first, I wanted to lose 30 pounds a year for the next 3 years. She said that was not aggressive enough, so now I have to lose 20 pounds by January 1st. This is going to be hard as hell since Thanksgiving and Christmas are HUGE food holidays for my family. I hope I like her once the work-outs start to get SERIOUS.

Alright, I should probably get some sleep for tomorrow. I have class at 0830. I really miss visiting my blog. I will be stopping by more often...

DiVa...Only one more month left before the end of the semester!

I got an A! I think I've found my element...

2007-10-23T20:41:00.000-04:00

Yesterday, I turned in my focused exam and I was a bit nervous. The focused exam is kind of like a little report that the doctor/practitioner does when you come in with a complaint. This particular patient had a skin problem. I decided to make it something not so complex because I realize that I don't have the knowledge base to make serious diagnoses yet. This time I sent my paper to the professor ahead of time for some feedback. I received the feedback just before it was due and luckily it only had a few things that needed to be amended. I made the changes and gave the paper to the professor. I said a little prayer because I know who's really in charge. So I went on with the rest of my day.

Yesterday was my day to do my very first female examination. I have had a gynecological exam many times before so I had an idea what was involved. And since I have been an L&D nurse for the past year, I wasn't very uncomfortable touching another women's vagina. (I know that probably sounds weird!) My biggest concern was making sure that I wasn't hurting the model and that my clinical presence was totally professional. The model was so professional. She was educated and understood her anatomy very well. She told us everything we needed to know about how to teach patients as we were performing the exam, how to re-assure a patient it was an amazing experience. She gave us feedback on how we did afterwards, which I thought was a little strange since it was our first time. I received outstanding scores in all areas. I was surprised, well only a little but because I am a DiVa after all!

This morning, when I checked my grade for the focused exam, I found that I had a 99%! I earned that grade this semester. My confidence has returned. My concentration is family practice nursing, but I am finding that I am very strong in women's health, which was what brought me to nursing school to begin with. Maybe I need to think about changing my major. Not, poorness has taught me to be a jack of all trades and master of none. I may double major in women's health. If I decide to deliver babies (add midwivery to women's health) that will have to happen later, mainly because it would add an entire year to my studies.

Right now I am working on a presentation for my health promotion class. I chose to do my presentation on the DASH diet. I had never heard of the DASH diet before, but it is a diet that was designed by the National Institute of Health for persons with high blood pressure. It is supposed to encourage patients to reduce sodium and increase fiber, potassium, magnesium and calcium. It is actually a really good diet. I am planning to try it when I get organized.

DiVa ...Almost caught up!

I have never been more happy to have a C!

2007-10-18T17:51:00.001-04:00

I finally got a "C" high enough to get me out of failing. If I hadn't changed one of my answers I probably would have gotten a B because I have a 79%! I know that someone is going to challenge a question or two so I am claiming a B. By my calculations, I need to get a 69% on the next two tests to get a C as a final grade. Or an 89% on the next two tests for a B. An A at this point is beyond the realm of possibility. Whatever I have going I will have to keep it up.

The one thing I did different with this test is that I joined another student for study. We met almost everyday last week to listen to recorded lectures and take practice tests. We paid a tutor $80 for four hours of review. When I wasn't at school listening to the lectures with my study buddy I was at home listening. Oh, and I spent the night at school the night before the test preparing my cheat sheet. Our instructor allows us to use a 8 x 11.5 piece of paper to assist us during the test. My sheet had 8 font, but there were some who used 4 font and reading glasses. I wasn't that desperate, but maybe next time.

Spending the night on campus was a really good idea. I didn't have to fight rush hour traffic to get to the test. I feel so much better now. I am not going to wait to get started on this next exam. I also had a meeting with the other instructor whose test I failed and she decided to give me a second chance to attempt the exam. I am so glad they understand that I need a little extra help getting adjusted. I guess it is better to share your frustration than to suffer in silence. In all honesty, I did need a little extra help, especially since I got surprised with this full scholarship and had to quit my job and then my nephew died. In the spam of two weeks my life was turned upside down. It seems that everyone is doing everything in their power to help me be successful. Now I need to hold up to my end of the agreement. Can you believe it, in another year I will be a nurse practitioner! And then a year later Dr. DiVa! I am so amp'd!

DiVa...Dr. DiVa if you're nasty!

Here I go again...

2007-10-15T16:57:00.000-04:00

I failed another test. Getting pretty good at it I must say. I studied my butt off, and still nothing. I am not giving up. I am forging onward because I am destined to be a nurse practitioner. That's all there is to it. Amazingly, I am not too far behind on my assignments. There is a light at the end of the tunnel. The powers that be are determining my fate as I type. I should probably be worried, but that isn't going to help so screw it. Well, I need to get back to my advance nursing skills studies, wish me luck!

DiVa...without words! (For a change.)

Finding my rhythm...

2007-09-30T14:49:00.000-04:00

Foreword
First off I want to say a huge thank you to all of you that stop by and visit. Overactive, Vixen and Steve, you guys are my cheerleaders. Thanks for being there. CocoaDawn, thank you for stopping by! I appreciate your compliments words of encouragement. I do this whole blog thing for people like you. When I first decided to return to school, there were no blogs like mine. And it is for people like you that I continue to blog, even today.

The Goods
I have still been fooling around with my daughter's father. I'll admit it, I don't think I can make it without his assistance. It lightens the financial load, that is when he pays the bills he is supposed to pay. Furthermore, I really can't rely on help from my family with my kids. So essentially, I think I do need him a little. But I realized recently that he is truly an a**hole. I felt sorry for him when he had his recent hospitalization and I let him back into my life. I know, I am stupid for continuing to let him back into my life but this is a lesson that I have to learn by busting my butt a few times. Lately, I realized that my self-esteem must be terribly low. I let him talk to me like I am worthless. He does absolutely nothing to help around the house and he swears that he has no money, when I know he does. We have no physical relationship at all, which for some might be okay, but the DiVa has NEEDS! And since I have returned to school he has gotten worse. I think that he thinks that once I become Dr. DiVa he will be living the good life. I gotta nip that in the bud, immediately. Even if that means that I have to get a job.

At first I thought that he was punishing me because he is sick and I am in good health. Not my fault, I warned his dumb ass about his obesity and blatant disregard for physical activity. As of late I am continually warning him to seek medical advice about this tumor on his brain. I guess he is waiting for it to metastasize or something. I told him that I was going to get a lover and he said he didn't care. Last weekend I went on a overnight trip with my ex and the kids and he didn't seem to care. I asked him to leave, but he refuses. Why on earth would a guy want to stay in a situation like that? The kids could care less if he is here or not. I told him what the ground rules would be if I left and he said I was a bitch. Why is it when a woman sets boundaries, she is being a bitch? I can't stand the sight of him. I am thinking of something legal to get him out of my house, more importantly, I need to figure out a way to keep him out of my life, except for being responsible for his daughter.

School is going okay. I need to find a way to correct my habit of chronic tardiness. I can't help it, I am late. Everywhere I go, I am late. I will probably be late to my own funeral. Despite that, my self discipline seems to be improving. I finished my assignment yesterday and it is due on Monday. As I was working on my focused exam, I realized that someday in the near future, I will be assessing patients and prescribing medications. I will be creating assignments for students, grading papers and acting as a clinical leader. I really need to get my stuff in order. Dr. DiVA cannot be late. Dr. DiVa should be organized. Dr. DiVa don't need to be relying on no man for nothing. Bishop T.D. Jakes was talking about the rhythm of being a woman today. And what he said was true.

As women, we have a natural rhythm that we maintain. It kind of reminds me of juggling how we have to manage our finances, keep the house reasonably clean, be a support system to the kids, and be the star student/employee all at the same time. This situation with my dude is a challenge. I have to prove to myself that I can do it without him. I've got a rhythm to maintain. He isn't doing anything anyway and he is NOT my husband. He is messing up my flow!

Well, I am supposed to be getting ready to take my family out to dinner for my son's birthday. Yes, I am now the proud parent of a teenager. My mother bought him an I-pod Nano for his birthday. I am still pissed off about the cell phone, so there are definitely going to be some rules about the I-pod.

The future Dr. DiVa...maybe if I think of myself as a doctor, I will be motivated to do the right thing!

P.S. If you want to email me feel free...nursediva06@yahoo.com

I flunked my first test

2007-09-20T17:59:00.000-04:00

I once told someone it's okay to fail a test. That failing a test is liberating. I am not feeling so free right now. This has been the week from hell. My best friend's son had a seizure that resulted in his death. He was only 21 years old. That is too young. He was such a sweet kid. He did not deserve that. My son was very close to him and he was devastated. It is very difficult to attend a funeral of a young person. I absolutely hated that experience.

My focus has been off. I cannot get into student mode. I was trying my best to separate from my employer, get my finances in order and manage my crazy life and I am having one hell of a hard time. I feel like crap. DiVA...a failure? This cannot be. In the history of my adult studenthood this is probably the second time I failed a test, that is not counting math tests which I have a tendency to fail because of my math anxiety. My personal life is in shambles. I won't go into details about it but I just feel like an awful human being. The house is a mess. I would cry, but what is the point of that?

Right now I need to make some decisions about what I am going to do. Am I going to make this school thing work? Or will I return to the world of floor nursing?

DiVa...HELP!

Having a roadblock

2007-09-16T14:03:00.000-04:00

I am feeling so unmotivated. At first when I started preparing for my graduate studies I had so much energy. Then all of a sudden, I realized that I am so far behind. I haven't been to school in a year. I have been on night shift for at least a year. Transitioning is a bitch.

I think I am finally on day hours, but I feel sleepy at around 9-10pm. This is my prime time study hours. I wake up at around 5-6 am, then I get the kids ready and then boom I am sleepy all over again. Unless I have class. I drink a white mocha and then I am on auto pilot until around 2-3. I have so much reading to do. My eyes start to swim after about 30 minutes and then the next thing I know, I am out.

One plus is that I am going to school with other women who are my age. They have children and many of them work. I had a job interview last week and I think it went pretty good. I will be a labor and delivery nurse again, working one day a week. That wont probably start until January. I am giving myself plenty of time to adjust.

I have a few assignments to get started on. I owe a health history tomorrow. It needs to be typed. Then I have my first big exam on Wednesday. I can take a cheat sheet, so I don't feel so bad. And then I have a few things to do for my health promotion class. I have a health promotion seminar that I have to create that is due in a few weeks. I have to create a presentation that can be taught over 2-3 hours. I wonder what I am going to promote? I guess I'll come up with something.

Back to the drawing board...

DiVa...too blessed to be stressed!

A new life...re-vistited

2007-09-05T03:47:00.000-04:00

I am trying my best to transition into my new life as a student. I am starting out behind due to the fact that I am still finishing the work schedule before starting school. I refused to leave my present employer on bad terms. They will still have crappy things to say about me. That is the type of women they are, only thing is, I don't have to put up with their crap anymore. And that's a good thing because I don't have time for foolishness. As a gift to myself, I bought a notebook computer. Now the kids will have the living room computer to themselves and I don't have to worry about them deleting my important papers.

To begin with, I am taking nine credit hours. Doesn't sound too bad to begin with, but I am looking at the syllabi. My first test is within the next two weeks. Then there are those little miscellaneous projects. Once I am finished with work, I think my focus will be better. I am looking for before and after school help with childcare which is running almost 200 dollars per week. That was an unexpected expense. My kids are relatively good kids, they argue alot and that alone is justification for supervision.

Speaking of the kids, my son came home from school today and said he took a test. He finished the test at top speed and the teacher called him up to her desk. As it turns out, seventh grade language arts isn't challenging enough so they are promoting him to eighth grade language arts. In the past, the schools have been giving me a pretty hard time about my son's behavior. They wanted to label him with ADHD and severe behavior disorders when all along I have been telling them that he is BORED, and nothing else. My daughter is more motivated than ever to become an attorney. At age 8 she already knows what she wants to do and how she's going to get there. I am going to attempt to teach the kids how to be more organized. We are all getting day planners.

I received a phone call today about a PRN job at a hospital that is conveniently located closer to home and school. The lady called to schedule a phone interview. It was right at the time that the kids got home from school, so the dog was barking, everyone had questions...in short it was a bad time to schedule anything. The interviewer's schedule and mine were in total conflict, but I finally agreed to a time that should work. Then the receptionist felt she needed to school me on the etiquette on phone interviews. She said, "Be prepared to receive a call at 1030, not 1035. Have your resume in front of you and any questions that you might have for the interviewer. Try not to have any distractions, such as children or barking dogs. Let me give you my number in case you have scheduling issues..." I was so insulted. I apologized and she stated, "Your noisy house doesn't bother me at all, it would just be very distracting to have all that going on during an interview." Whateva, bitch. Does she really think I am that stupid? Well, time to get the kids stuff together for school.

DiVa...Professional nursing student, Mom first!

Back to School

2007-08-30T05:03:00.001-04:00

This week I spent most of my time and money getting my kids ready for school. I won't say how much money I spent, but I am broke as hell. Who could have thought that crayons and notebooks and other miscellaneous crap, (that the schools will be asking for more of by December), could cost so much money? Oh well, my kids don't need to ask me for nothing else for a very, very long time. Besides, they aren't the only ones returning to school. I am too.

The DiVa is returning to school to finish her master's degree and eventually my PhD full time. This semester I am registered for 9 credit hours. Thank God I don't have to work. That's right, I don't have to work. My former university loves me so much, they are paying my entire tuition, books, miscellaneous fees and they are giving me a monthly stipend for my living expenses. This is a huge blessing. I have to take back everything negative I ever said about my school. They believe in me, even though they have the strangest ways of showing it. NurseDiVa, the professional scholar.

So in order to accomplish all this, I had to quit my job. Just as I started to really know what I am doing, I am leaving. I have mixed emotions about leaving the job, mainly because I feel I am losing my sense of security. There is something about relying on someone else for financial security that just makes me cringe. Secondly, I kind of feel like I gave up. Well, I didn't give up I got a better offer. I also take issue with the concept of becoming an advanced practice nurse with only one year of nursing experience. I will find something PRN to keep me busy in the meantime, but I can't imagine working more than 5 days a month. Mainly because I will need to have time to spend with my children.

I am just beaming with joy and pride that I didn't let this crazy job beat me. I still have another week to work until I start classes, but everyone knows that I am leaving. I will actually miss the job. I am also worried that the patients who are mainly minorities are losing one of their best advocates. I imagine that someone else will come along and take care of them, but I still worry a little. My mother is so ecstatic. She has called everyone in the family and told them I am going back to school. I am excited to have a life again. If school is the only thing I have to do, I might actually get to have a life with friends and family. More importantly, I have some huge shoes to fill. Right now, I have a lot of people looking up to me that will kill me if I let them down. They have nothing to worry about, I am going to be the best damned nurse practitioner/educator ever!

The future Dr. NurseDiVa...sort of has a ring to it, don't ya think?

Today is my puppy's birthday...

2007-08-20T06:25:00.001-04:00

He is one year old today. I can't believe he made it. I never had a pet as a kid. Only a goldfish and of course goldfish don't require a whole lot. I must say, having a puppy is like bringing a new baby home. He still isn't potty trained. But in October, he will get it together because I will have the time to teach him.

I want to give him a little party. There is a pet store where we live that makes puppy cakes, maybe I'll buy him one of those. And the kids can make him a nice dinner of Purina one and mighty dog beef dinner. It should be pretty fun. Maybe I'll invite the neighbor kids and put some hot dogs on the grill. I am so excited!

DiVa...Now why does a dog need a birthday party?

The REAL reason why there is a nursing shortage...

2007-08-18T08:13:00.000-04:00

Being a nurse is a stone cold trip. If you choose not to "play the game" one can easily end up on the shit end of the stick. And in all fairness, I think that applies to all nurses regardless of color. But if you are reading this and you are a minority nurse, I think you know what I mean. I first noticed it in nursing school. It started with little nuances that are designed to weed out those who they "think" aren't going to make it. Most of the time, my school worked with me and my family situation. But there were those occasions when it became clear to me that they really didn't care about me or my family situation and that I needed to make a choice between being a mother or a nurse. While that is clearly not a choice I decided that I needed to see this thing through because I knew that if I quit nursing school it would be impossible to find a job to pay that private college tuition that was accruing with the federal government. Despite my family problems I had a solid GPA that was a true indication of my talent and drive to be a nurse. Don't misunderstand, nursing is my passion. I didn't get into it for superficial reasons like money or power, I love taking care of people.

I thought it would be different once I became a bonafide registered nurse. Think again. In the workplace, I have noticed that I get special attention that other nurses tend not to get. Even other new nurses. I am a new nurse, but a competent nurse. I noticed that if I ask a question, I get snubbed because perhaps maybe it is a question that people think I should know the answer. But if I don't ask a question and there is a marginal outcome, I am held accountable. I don't have a problem with being accountable at all. If I made a mistake I own it just as well as I own the things about my performance that I am proud of, it is part of my growth as a human being and an example of the splendid person that God created. I love my mistakes and great accomplishments, but damn! Is it a learning opportunity for EVERYONE? It is discussed in the conference room, in the break room, at the nurses station...wherever. And without regard to my feelings or need to have a healthy self esteem as a nurse. Sometimes, before I even have an opportunity to ask for help, I will turn around and there is a room full of nurses, which can be a good thing. At first this was a welcome sight because I knew that someone had my back. That was until I got called into the office about my performance. I talked to the charge nurse and she told me to politely ask people to leave if they come into my room on some bullshit. I can't tell whether or not it is bullshit or sincere help so I am a little cautious, which can be both to my benefit and/or my detriment. I was warned that one day I will call for help and no one will come. If that shit happens, I guarantee that I will not be the only one in trouble.

In my culture, you are to demand respect from others. That's how it is. Watch your mouth when you talk to me, treat me with the same respect that I treat you with. Or else. I do NOT kiss ass. Let me say it again, I DO NOT KISS ASS. I feel like I am just as good as anyone else. I am not going to sit around and gossip to the others about you. I will tell you to your face. The next day, I will still treat you with respect because that's how I am. Not at my job. One day I talked to someone about something that they did that I didn't like and she was so nasty, you would have thought that I had disrespected her. I followed the proper format too! You know the one that goes, "I didn't like it when you _______. It made me feel like_______, and I would appreciate it if in the future you would ________." There is no good way to give a nurse feedback. It is always misconstrued. Maybe I should try a different approach like, "I think you are a great nurse, ______. I respect your expertise and admire your style. But, it really bothered me when you _________. It made me feel like _________. I really want us to have a good working relationship. I would like it better if you ________. I hope you don't take this the wrong way. I truly value your friendship." Hell no, that is kissing ass. And besides, people aren't that nice to me. They will tell me off in front of anybody. The doctors, the patients, other nurses...whomever is present. But if I do it, no matter how I do it, I am defensive and mean. Ah, whatever. Sometimes you have the be the bigger person. But must DiVa always be the bigger person, taking the high road?

And the saddest part of all is that there are two other nurses that belong to my ethnic group, both more senior and more experienced that me. One is very helpful. The other treats me like crap. If the roles were reversed, no one could say shit about either of them in my presence. I would defend them to the end. The more senior of them has done everything possible to help me in my troubles as a new nurse. Without her help, I would not have made it as far as I have. And I understand that there are limits to the help she can give me without compromising her position. People respect her opinion and she is the one thing that keeps our unit afloat. Without her, our floor would be crap and everyone knows it. I can only hope that one day I can be as good a nurse as she. The other, she's in with the clique of nurses who sit upon the throne of nursing goodness and cast stones at those who choose not to participate in their brand of ostracism. I guess she really needs to be a part of their group, being snobby to others. She is so nasty to me that I have stopped speaking first. In my culture, if you see someone first, you are supposed to say "Hello." It's just one of those things my grandma taught me when I was little. There have been times that I have spoken to her and she acted as if I was invisible. I talked to her once and asked her what I ever did to her. She couldn't pinpoint anything. I told her that she wasn't a very nice person. She didn't sound surprised. She was nicer for a couple days and returned to being bitchy. Oh, and then there was that one day she implied that I was a bad mother because I don't allow my son to operate the lawn mower unsupervised. That isn't a very big deal, but it still pissed me off. It is clear that she thinks that she is better than me because she grew up in the suburbs and had the finer things in life. I learned something a long time ago that I take to work with me everyday. The worst possible situation that a person could have could easily happen to you. Never think of yourself as better than someone else just because you have more education, or money or more anything. You never know where you will end up. All that ass kissing that she does must pay off because people don't mess with her like they mess with me. The absolutely LOVE her.

The clique. I have found that if this group of nurses spend all their time pointing out the flaws of other nurses, then no one will notice that they aren't that great begin with. I imagine that they treat me like that because I choose not to hang out with them or attend their parties or say anything negative about other people. I can't trust bitches like that because if they will talk bad about others, they will talk bad about me and I don't play that. I don't tell them my business. They don't need to know nothing about me. In a way, I wish I could have friends at work but a the same time with friends like that, who needs enemies? This sort of behavior is not exclusive to the nurses on my floor. Doctors can be just as bad.

It seems to me that if there is a possibility that a situation that might have an unfavorable outcome, the doctor will find some way to make it a nursing issue. I cannot write prescriptions. I have not reached a level of expertise where I can question a doctor's judgement. Nor can I make any suggestions regarding the plan of care. I can only voice my concerns and document interventions the rest is up to the doctor. Twice in my short career has a doctor tried to shift the blame of a situation that had been going on ALL DAY on me. They need to settle the feud between them and family practice and find a way to work more cooperatively. Otherwise, family practice physicians should not do OB. Period. We are all on the same team. I strongly feel that medicine is a collaborative process. It is not us against them.

Whine, bitch, moan. Oh DiVa, you are the perpetual victim. This is my blog and I can talk about whatever I want but damn, wouldn't it be nice to hear me speak of my glowing experiences as a nurse. Wouldn't it? I am always doom and gloom. I have had a few nice deliveries, but it is always foreshadowed with drama. I am still wondering when I will be treated with the same respect and professional courtesy that I treat others with. I could always quit this job. believe me, I have had offers, but at the same time I feel compelled to stay. Maybe it is because I refuse to let this job beat me. Or that I feel like the patients need at least one nurse that really cares. Call me crazy. I guess I can control the stuff I write about, but in all reality, I don't have anyone to talk to about the stuff I experience as a nurse. No one that would understand anyway. I am sure y'all don't mind. I heard that it is like that everywhere. Can this be true?

DiVa...trying to make the best of a bad situation.

Addendum: I didn't even mention the long hours, low pay, lack of time for family/household responsibilities, huge workload and lack of recognition for service.

Who does she think she's talking to?

2007-08-11T17:03:00.000-04:00

I was taking care of a patient who was having twins and singleton patient. One in active labor, the other a pitocin induction. My twins mother was a primipara pitocin induction, but I hadn't started the pitocin yet because she was contracting just fine. Her blood pressures were higher than normal and since she was a G5P0, I had the doctor review her pressures and labs were ordered to check her for preeclampsia. The other was a multiparous patient who was real uncomfortable. Nurse B was in the same nurses station taking care of a chronically hypertensive mother on hydralazine because her pressures were sky high. The shift had just started. I hung my medication for the twin mother when I happened to look up at my singleton mother and noticed that her tracing was looking kind of strange. I went to visit my singleton mother and she was looking like her butt was about to explode. So I put on a sterile glove to check her and the baby was crowning. I run to the intercom and call for assistance immediately. No one came. So then I ran out to the desk and called two more times. Finally many people come into the room and the mother pushed out a healthy baby boy. In the meantime, Nurse B took care of my patient. I gave Nurse B a quick report and she watched my patient for two hours.

During that time, Nurse B knew the situation with the elevated pressures on the twin mother. She knew that labs were ordered, she didn't draw them because her tracing was bad on her chronic hypertension mother. I didn't hold it against her because I knew she had the more difficult patient. As soon as I finished my delivery, I got all of the charting caught up and got the labs together to assess her elevated pressures. Nurse B was aware. The whole time I took care of my twins, the mother was throwing up, violently. Her labs came back normal and the MDs decided not to treat her with magnesium sulfate. Despite all that, I had a foley placed for her comfort. In the meantime, I talked to Nurse B and we were having a pretty nice time working to gether. Her chronic hypertension mother delivered vaginally, which was quite a feat considering her tracing and all the drama with the Doula. During her delivery, I got a new patient that was Spanish speaking and 6cm dilated. Not a problem for the DiVa because I speak Spanish. I knew this patient was going to go very quickly and it was no suprise when she was completely dilated within two hours of being brought to the room. By that time Nurse B finished her recovery and had to take over my twins...Again! Let me put emphasis on AGAIN.

The tracing for my spanish speaker was not looking good and it was time to push. Nurse B asked me who was watching the twins. Obviously, no one because all this happened rather quickly. She was done with her delivery so she knew that she was going to be watching her again. We are holding legs and pushing with my mother when she says something like, "So are you gonna give me report?" Meanwhile the chief resident is yelling at me and the first year like we were idiots. This is amazing to me because the chief was quite inept just last year and now she is shot callin like she really knows what time it is. Any reasonable human being could see that it was an inappropriate time to ask for report because I am running crowd control, trying to find a fetal heartrate, keeping the mother calm, trying to remember how to conjugate Spanish verbs and accomodating doctor's requests. I ignore Nurse B and give all of my attention to the delivery. The baby comes out limp, purple and barely breathing. I am FREAKING out. I run the baby over to the warmer and call out for the charge nurse. I run back over to the warmer and rub the baby really hard. I bag for a few seconds so that the baby has a little extra oxygen before I start suctioning.

Just as I am doing that the charge nurse turns the corner and of course the baby is crying. He's juicy, but crying which is a good thing. The charge nurse says, "You're alright and if you need help just call Nurse B." So once the baby starts crying the requests start rolling in, "I need Vicryl." "I need lidocaine." "I need more lidocaine." Here comes Nurse B, "Are the doctors aware of her blood pressures?" She knows about this patient, at least as much as I know so why is she asking me these stupid questions?

I'm a NurseDiva, even at home!

2007-08-01T14:03:00.000-04:00

As you know I am a DiVa and a Mom. I love being both but sometimes, I like to leave the NurseDiva at work. When I work, my FOB watches the kids. It's free and Hell, it's his responsibility. So Saturday morning, when I came home to find him passed out on my couch my nursing super-powers began to tingle. When I finally woke his dumb ass up I asked him what was wrong. He said something like, "I am having the worst headache of my life." I was thinking, Damn, I haven't got that life insurance policy, yet...this bastard better not stroke out in my living room!"

I will be back to tell you what happened next after I take my son to his physical.

DiVa...

Alright I am back. Where was I? Oh yeah, so my FOB was having the worst headache of his life and I was regretting not having gotten that life insurance policy. I told him to get up right now and go to the hospital. I went with him and when we arrived I said a phrase that I knew would get him a room immediately. I said, "I think he's having a stroke." So they did the "hold your hands out" and "smile" tests. He passed. They asked me why I thought he might be having a stroke and I told them about his headache. They tried to take his blood pressure and it was unmeasurable. So then they take him to a trauma bay and hook him up to the monitor. His blood pressure still wouldn't register. So they keep trying and finally a blood pressure of 248/161 came up. Amazingly, they did not panic.

They tried to start an IV and had problems gaining IV access. I volunteered to help and we found access. Then they gave him medications in his IV. He got 60mg of labetalol and even after that his pressure was 199/136. I am freaking out and somewhat regretting my decision not to take him to the county hospital, but at the same time I didn't want him to code in my car. Long story short, they kept him in the hospital for three days and discharged him. Do you think he so much as thanked me for my help? Not him. I was almost having a moment of weakness, until he got smart. I should have let his ass have that stroke he was trying so hard to have. But I was trying to help. He is so goofy. Right now, he hasn't eaten anything because he is on a 1500mg sodium diet and he has no idea what he can eat. I would help him, but he has an attitude. For all I care, he can eat salad everyday. I am half tempted to order his favorite pizza with pepperoni, sausage and bacon and leave it on the counter steaming hot and cheesy...

But you know I am not going to do that. I will be nice and grill him a piece of chicken and steam some rice and vegetable. I might even measure the correct proportions so that he doesn't overeat. Hold on. He doesn't live here. He better pack a lunch!

DiVa...letting a grown man be a grown man for a change!

Baby Daddy Drama

2007-07-29T13:26:00.000-04:00

The last night that I worked I had a patient that was around 35 weeks. She was at a party having a good time when her water broke. So she came to the hospital with her mother and boyfriend in tow. Her boyfriend whom I call Bachelor #1 was sitting in the corner with his mirrored aviator glasses on. Her mother, who I thought was her older sister, looked like she thought she was 25 years old when obviously she was at least 40 years old. I imagine the party must have been a luau or something, sounded like a good time. Anyways, I got her settled into her room and on the monitor. During her assessment Bachelor #2 comes into the room. He was short, slightly overweight, cute but not as handsome or charismatic as Bachelor #1. He said hello and I invited him into the room and he quickly excused himself outside. So Bachelor #2 and The Mother were in the hallway talking and then they left the floor. The Mother was like "Hey Bachelor #2, come back!" And I was like, Okay....this is going to be interesting.

So then I finished getting the patient settled in and I run her labs. The patient was sitting there in the bed looking mildly inebriated or delayed. In comparison to the extremely attractive cast of visitors she had, she seemed quite plain. I am asking her questions and she is smiling and barely answering. For a moment I thought she had some mental delays but as I would soon find out she was just fine. Most of the time she was on the phone, which I found to be mildly irritating. So I left to let her finish the conversation. Then The Mother and Bachelor #2 round the corner and enter the patient's room. I asked the patient what she planned to name the baby she said it all depends. I knew very well what that meant so I didn't pry.

So here I am sitting at the nurse's station catching up on some charting when suddenly I hear Bachelor #1 say something like "I hear all that talkin', but you ain't walkin' you don't want none of this." and then Bachelor #2 says something like "I'll beat your ass!" And then The Mother says something like "Come on guys, let try to have some peace in here, let's be calm." By that time I am outside the door and I say "Yes, let's keep in quiet in here because after all this is a hospital." So Bachelor #2 looks to me and says "I don't know why you come in here for smiling and saying shit. You don't even know what's going on, this ain't no smiling matter." And I tell him, "I don't want to know what is going on, it's none of my business. It is my business however to maintain a safe environment for my patient. If you can't do any better than this I will need to ask you to leave." He said something smart and I said, "I am being nice right now, but I will call security." I told the patient, "Handle your visitor issues or I will." Then Bachelor #2 got up and left and The Mother ran out behind him.

When I looked at the patient and assessed the whole situation, I surmised that Bachelor #1 was the one she wanted to be the baby's father. Bachelor #1 was a worldly man. He told me that all his ladies have their babies early. I asked him how many ladies he had and he proudly stated that he had three. The patient was smiling and laughing. It was his first time being there for the birth of any of his children. This was not cute at all. Bachelor #2 had passion, I almost admired him for his determination. Even though he was smaller than Bachelor #1 he was standing up for his right to be there. It was clear that his presence was not important to anyone, except The Mother.

Next to the patient it was The mother that I was most disappointed with because she was encouraging this whole situation. The mother could have managed that by not showing favoritism and being more concerned about her daughter's well being, not the comfort of the men. The patient was obviously enjoying these two men fighting over her. It was very immature of the patient because she was 29 years old. Not 16 or 19, but 29 years. She was having her first baby and bringing it into a whole bunch of crap. Why couldn't she not let ANYONE be there until after the paternity test? What I hate most of all is that the NurseDiva has to be in the middle of all of that garbage. How on earth does one maintain a therapeutic environment when you have to referee? I could have just called security, but I like to give people a chance. Let's act like ladies and gentlemen...

DiVa...Another entertaining night at the county hospital.

How many phones must a DiVa buy...?

2007-07-27T15:41:00.000-04:00

Okay so I have bought two cell phones in the past few weeks and I have to buy one more. One night my cousin and I were driving around town and she was drunk...(as usual). Somehow, she managed to drop my cell phone in an uncovered drink that was resting in the drink holder. How the hell she did that, I don't know but she didn't offer an apology and God knows she is broke as a joke. This heifer never has any money to fund anything. I was pissed off a little bit, but I was looking for a way to get out of my contract with my mobile carrier anyway so I went to a local cellular dealer and got a new phone. While I was there, I got a phone for my son too. Then he went to a local festival and a couple of teenagers roughed him up and took that phone from him. Sigh...there's another $150

The day before yesterday I got a pedicure and manicure. Now I need to get more sandals to show off my gorgeous toes. I love shopping. I am a woman, what can I say? I go to work everyday, I deserve the finer things. But first I have to get ready to buy school clothes for the kids. One of my children wear uniforms, the other doesn't but now he wears adult sized shoes. All of a sudden my 13 year old needs name brand shoes. He used to be happy with his "buddies" but now he wants to style and profile. But even the "buddies" cost almost $30-$40 a pair. I blame it on the gas prices. I am so not ready for a teenager...

Did I tell you that I survived a year at my job. Yes, I made it! The Diva has been a L & D nurse for an entire year. No one has gotten choked yet and I got a whole dollar raise. Woo-hoo! One whole dollar. I have yet to see the difference in my check because I work overtime, but soon I will get back down to my normal 36 hours. And in addition to all that I have confidence. That is almost better than the raise. I have had a few bad situations, I know what one looks like and what to do...CALL THE CHARGE NURSE. I know that sounds scary. But just imagine what it must be like on our floor on my shift where almost ALL of the nurses have been nurses for less than 3 years, and besides those three or four people, everyone else has had less than a year to six months of nursing experience. And on my floor 3 years is considered experienced. I am pleased with myself. very pleased.

In the past year I have seen many things, I have helped mothers say goodbye to their babies. I have taught mothers how to take care of their babies and themselves. I have brought families together and opened up lines of communication. I have found my voice and learned how to stand up for what's right even when it was not the popular position. I have learned how to advocate for my patients. I have learned when to speak up and when to stand down. I have laughed and cried. Nursing school did not teach me those things. But nursing did. And even though I bitch and moan about how things suck from time to time I must say that at this point, I have no regrets. Labor and delivery is not always a happy place. Babies and mothers die. But this is the commitment I have accepted and I am proud of myself. I do this nursing thing with a style all my own. I can only get better from here. And watch out for me when I hit Labor and Delivery NurseDiVa status!

DiVa..the SUPERSTAR of labor and delivery!

Another on bites the dust!

2007-07-26T12:03:00.000-04:00

Yet another nurse has quit our fine labor and delivery unit. It is no surprise to me, and in a way I am glad. Of the 10 nurses, oops 11 nurses that quit in the past few months a good number were bitches. Eventually the best nurses will remain. I will just bide my time. Things are getting better for me and at this moment I am just going to wait and see what is in store. The good thing is that the nurse that is leaving is above me in seniority, meaning my name moves up the list. The only thing I need to worry about at this time is gathering the nicer nurses and trying to make our unit more fun so that people below me in seniority will stay. There are still quite a few nurses on the dark side and the attraction is strong. Maybe more nurses on the dark side will quit or cross over to being real helpful nurses to the newbies. It will be our job to re-define team nursing.

It's almost time for the kids to return to school. In a way this makes me sad because I haven't really spent the time with them that I would have liked to and in a way i am glad because they were getting bored and eating me out of house and home and making huge messes. The puppy will miss them terribly. We are planning a 'Back to School' party for the kids in the family. I am one of the sponsors. I am trying to think of some fun stuff for the kids. I hope that the weather will cooperate. My son is still playing football. Yesterday, when I picked him up from practice, he was covered in dirt. I asked him what happened and he said he got tackled. Instantly, visions of him with broken limbs came to mind. Lately we have been hanging out. I talked to his father about giving him manhood training. My son hates good hygiene. I can't understand why he doesn't like to bathe. His Dad really wants to help out. It's about time, he is almost 40 years old! My daughter, is spending the rest of the summer with her grandmother. I can't say that I approve but it is good to get sleep during the day. I bet she will be so big the next time I see her.

Dating has been quite a disappointment. I have resorted to just being alone, which is okay. Guys nowadays are uninspired, of the gentlemen that I have talked to lately the only thing they want to do is have sex. Sex is okay, but I want to have more of a spiritual connection. And besides, a day doesn't go by where I haven't seen a patient in our unit with herpes, trichomoniasis, chlyamidia, bacteria vaginosis or HPV (genital warts). We have also had an occasional case of HIV and Hepatitis C. Not that I plan on having unprotected sex with anyone, just the idea that girls are picking this crap up out there is just plain scary. And they come in with their boyfriends, significant others and sometimes husbands like no big deal. Having an STD and knowing where it came from would piss me off...BIG TIME. So instead of dating a few friends of mine have decided to travel locally and just have fun. You know, like a girls night out.

I went to a Casino this past weekend. It was fun. I didn't make any money because I gambled the $60 that I won and put another $60 with it. I have to learn to quit while I am ahead. This Casino only had slots. I have yet to figure out how I am winning, that is when I win. I just get really excited. Then I lose. I started asking the people sitting next to me how the whole thing works. Basically, I play the one, two, five and ten cent slots. Anything more than that makes me nauseated when I lose. I guess you have to do the max bet every time in order to win money. On a one cent slot that could be as much as 25 cents per bet. But on a dollar slot that could be as much as 5 dollars...not happening! The next time I go, I will not go with people who are afraid to lose money. I am comfortable with losing maybe 100-200 dollars and nothing more.

Speaking of returning to school, I am seriously thinking on getting back into the swing of things. At first I thought that I needed to adjust to working and give myself sometime to find my place. I think soon I will register for classes. We will see and I will keep you posted.

DiVa...getting more proficient at DiVaDom one day at a time!

Team nursing...WTF?

2007-07-21T12:36:00.000-04:00

Since I have been a nurse on my own, I have always known that the consensus of my peers was that I have no idea what I am doing. So recently, when a few of my alleged colleagues were taking over my patient responsibilities and treating me like a patient liability I got well...a little snippy. I am very protective of letting people come into my room and get into my business. Only because when I do invite someone to participate in my special brand of nursing, it always results in someone going to the office to report me and then me getting into trouble. Most recently, a group of colleagues went into the nursing office to report me and got a huge surprise. Here's what happened.

A few nights ago, I was assigned to take care of a trauma. She was 28 weeks pregnant and her baby's heart rate was in the 100's. Not good given that it should have been in the 110-160 range. So I and the charge nurse go running to the emergency department preparing for a crash c-section in the trauma bay. By the time we arrived, the fetal heart rate was back to normal. The patient had multiple injuries. A broken arm, a broken nose. A few fingers were injured in addition to her back, ribs and a banged up head. She had on a c-collar which she was dying to take off, but she needed a MRI and various scans so that she could be cleared. The trauma doctors decided to clear the patient in our OB unit because I think that secretly, they hate having children or pregnant people in the ED. So I return to our unit.

Now, in our observation unit there were already four nurses. Very nosey nurses that can make you have a really bad night. I did not want to work with them because I knew what kind of night I was going to have. Of course the charge nurse assigns me to the trauma patient who was transferred to the observation unit. When I get over there, there are a few nurses in the room. There was nothing for me to do with regard to getting her settled in, but I refused to go and sit at the desk while they admit her because in my mind, she is my patient and the first thing that will be said is that I am incapable of managing my patient and that is why they took over. I was trying to organize her chart and one of the other nurses asked me for it. It was an hour before I ever even got to talk to my patient. It really pissed me off, but I let it slide.

One of the other patients in observation called out to go to the bathroom. I didn't want to take her out of bed because I didn't know her story. I went to ask one of the other nurses and she talked to me like a kid telling me to take her to the bathroom. So then the same nurse asked me to watch her patient while she transferred another and when she came back she asked me to watch her patient. While she was gone the patient came off of the monitor, so I went in to put her back on and she asked me to leave the room. She was really nasty and so I told her in my "back da F--kup" voice to let me finish what I was doing. When I returned she was giving report to another new nurse and told her that if she had a question to find her and ask. As if I am incapable of answering a question. We started at the same time! How could she possibly be in a better situation experience-wise than me? That sent me over the edge. I made it pretty clear that I was about to quit. No one said anything to me for the rest of the night. Good!

So when I came in to work yesterday, I heard that the nurse manager wanted to speak with me. It was no surprise that these bitches had gone to the office and reported what happened. My boss said that they came in and said that I was unapproachable and defensive and that someone should talk to me about my attitude. My manager said she asked them why and she said that they thought that I misunderstood that they were trying to employ aspects of "team nursing" and that I was overly sensitive. I wonder, does team nursing include sitting in the conference room talking about how stupid I am? No one keeps a secret on my unit. I know just about everything they say about me, and what they don't say, I can pretty much figure out by the way they watch my tracing from across the unit, or run into my room when the baby is having a harmless variable deceleration.

The nurse manager really didn't allow me to say too much. But I was able to slip in the fact that I am justified in my defensiveness and amazingly she agreed. She told me that she asked them if my actions created a patient safety issue. They said no. And she said she told them to leave me the hell alone. (Amazing....) She warned them that if they were to do that crap to a senior nurse they would get their feelings hurt and that they would be told to get the hell out of the room. The the nurse manager told me that both of the reporting nurses agreed that my performance had greatly improved. (WTF...?) I asked her why they have an opinion on my performance and why it counts. She explained that she cannot work every shift to observe each nurses performance so she relies on peer review as a monitoring tool. She went on to say that I could critique their performance as well. (No thanks!) I have no desire to nose around in another nurses business unless there is a patient safety issue.

I guess I was surprised that the nurse manager took up for me, (Finally!) but at the same time I am pissed off that those bitches actually thought they were doing something. How the heck am I supposed to know the difference between help and meddling? And the nerve of them to say that I am doing sooo much better now. What was I like before? I must have been a freakin' train wreck! I think that right now my boss will do almost anything to keep people from quitting since we've lost almost 10 nurses in the past six months. In a way I want to remain "unapproachable" so that maybe those heifers will check themselves before they step to me with dumb shit! They used to come in my room and take over, often times telling me to move out of the way and let them handle whatever was going on, or calling for a resident to assess my patient when the resident and I would already be in the room taking care of business. Maybe now they will at least ask me if I need help before they come barging in. Team nursing my butt, if I come in their room and offer help they politely ask me to leave, but when I do that I am being "unapproachable and defensive." I just want those jerks to leave me alone and let me do my job. Respect me the same way I respect you.

Just in case, I had an interview for a position in a hospital closer to home. So now, I might be a emergency room NurseDiva extraordinaire.

NurseDiva...just fakin' it until I am makin' it!

An exasperating week...

2007-06-26T06:28:00.000-04:00

This past week I have had some kind of week at work. I had a patient with a blood sugar so low it was undetectable by glucometer (the patient was 10 weeks pregnant a type 1 diabetic and chronic hypertensive), a preemie delivery that went off without a hitch (The mom had severe pre-eclampsia and went into labor at 33 4/7 weeks delivering healthy baby that had a dubowitz score of 35-36 weeks gestation and a blood sugar of 4!) and a vacuum assisted vaginal delivery, (a 17 year old with + Human Papilloma Virus that I found out about on palpation, eww! Then her baby's heart rate took a dive into the 60's in transitional labor. Thank God we didn't have to do a c-section). It is so good to have some time off. My kids and I went to see Blades of Glory my first night off. I really should have put a bit more thought into movie choices before considering this film. There were a few scenes where I had to cover their little eyes. Most of the adult jokes were over their heads, besides all that it was hilarious!

Last night I had my first date with Jeff. Unfortunately, it did not happen. I don't know why, I am disappointed but I am not going to sweat it. I am sure my cousin put the kibosh on that because she wanted him, even though she has a boyfriend. I could care less. The electrician has seemed to change his tune, a little. He has planned a date for us on Saturday to go bike riding. I am refreshed to have a date that is something besides dinner and a movie. However, he seems very anxious to come to my house late at night. I think I can manage this guy; it will be good practice for the real thing and a lot of fun. I feel a little apprehensive, especially when he said he has never been married and has no children and he is at least 40-50 years old. We are only friends at this stage so I guess it doesn't really matter, but at the same time I feel like if I hadn't spent my time kissing frogs and worked more on my career I would be a better prospect. Despite all that I am still cute. What ever the universe has planned for me will happen in its own due time. I still have a lot of "housework" to do anyway.

Tonight is my last night off. I am planning on buying a new bed. The store is holding it for me until I can pick it up. Then I am going to move into the basement and get rid of my old bed. The new bed is a king size bed. I wonder if it will fit in my new room. Anywho, my plan is to give my daughter my room and my son will have his room to himself again. It should work out to give us all our own space, even though I predict that my kids will spend most of their time in my room. This should hold us over until I can get me stuff together for buying a new home. After the next week or so (working almost seven days in a row, including the holiday) I will have some time off. Until then I will make the best of my last day off provided that is doesn't rain.

DiVa...Into our lives a little rain must fall. But if it weren't for the rain, we wouldn't have rainbows!

Updates and such...

2007-06-22T15:56:00.000-04:00

On dating...
Okay, so I called this guy that I met at the job. (The electrician) I was initially very excited and optimistic about what could be and when I talked to him I found out that he is a little bit arrogant and self absorbed. I probably won't be calling him again. Here's what happened. I decided to call him one night before I went to work and he didn't answer his phone. I thought "Whew!" when all of a sudden, my phone started ringing. It was him returning my call. Do I answer, or make him leave a message? I answered and he sounded like he was in the bathroom.

I said, "Hi, it's NurseDiVa. I met you a few mornings ago and you gave me one of your business cards." He says, "At the hospital?" I said yes. He said, "What floor?" I said, "Labor and Delivery...?" He says, "Oh, the baby floor." (Not sounding so good.) I said, "Yes..., the reason why I called was because if you are not seeing anyone, I though it might be nice if we got together for lunch or coffee or something. You seem like a really nice person with whom I'd like to be friends." He said something like, "I don't do coffee." I said, "Well what Do you do?" Basically he said he likes to work out at the gym and admire himself in the mirror, Oh and make money. *insert deep exasperating sigh....

After that conversation he wanted to come up to the job and meet me for lunch. (Hello, night shift?) He left two messages on my phone. I returned his call yesterday. I dont think he remembers me. I think he wants to see me before he makes any kind of plans because he wanted me to page him to our floor before the end of my shift. I bet there is a nurse on every floor that has one of his business cards/pager number and to be honest he didn't deny it when I made a joke to that effect. Whatever...

I met a nice guy at the drugstore yesterday. he had seen me at a party a month ago and I left before we had a chance to meet. His name is Jeff. I don't know much more about him. In all honesty, I thought that my cousin wanted to date him so I never gave it a second thought, but now that she is dating another guy I guess he is fair game. We exchanged numbers and someday I might call him too! That is if he doesn't call me first. I think I like calling first since I have tried it because I feel like it gives me a certain sense of control over the outcome. I don't know if I will be talking to the electrician again and if I do, we will be ONLY friends.

On the job...
Suddenly, it seems like everything has clicked and I finally know what I am doing. For real this time. I was wondering when it was going to happen. It has taken almost a year to get myself together. People have always said that it takes about a year to feel like you know what you are doing. I guess that is true. One of the hardest lessons that I think it has taken me to learn is not to sweat the small stuff. And believe me, about 90% of it is small stuff. Being on a first name basis with a doctor is not so awkward anymore.

I am not as afraid to express my opinion on the plan of care, or discuss aspects of the plan of care that I am uncomfortable with. It is becoming easier to ignore people with attitudes, accept mid-shift assignment changes and discern REAL emergencies from potential emergencies or things that just need to be watched. For the first time in a long time look forward to going to work. I have even learned who to ask for help and who not to ask, because believe me you cannot ask everyone for help. Some people will give you bad information and then pretend like they didn't advise you when it doesn't work out. Or they will report you to the nurse manager for being inept. I am glad that I stuck it out.

On family life...
The kids are making me crazy this summer. The house is a mess, there is no food and sleeping is nearly impossible. But we are working it out. My son is going through this independence phase. I have to get him in check now because he is approaching the unruly teenage years and I am the law. He did get up this morning and get himself ready for football conditioning. He made sure he ate a well balanced meal, got dressed, I must say I was impressed. My daughter is still my baby. She is getting taller and more independent. Soon, no one will need me for anything. But I still think it will be a while before I can trust them to get themselves ready for school unsupervised.

DiVa...counting her blessings and loving life at the moment!

Scrubbing with the enemy...

2007-06-19T18:30:00.000-04:00

I was scrub nurse last night on a C-section and the doctors were not in a great mood. The first surgery started out as a crash turned non-emergent. As I understood it we were not in a hurry. In an emergency, we do not have to opportunity to perform what is known as a pre-operative count. In the pre-operative count we establish sort of a baseline inventory of equipment that we are starting with to perform surgery. Since the first surgery was not an emergency a count should have been performed, but the doctor grabbed instruments off of the field before they could be counted and started the surgery as if we were ancillary staff instead of licensed professionals who assist in making sure that the surgery is being performed safely. As a result, an x-ray had to be performed. Not a bad thing, but would not have been necessitated had the doctor given us an extra three minutes to finish the count. The x-ray came back unremarkable. Everything turned out fine.

The thing that probably pisses me off the most was that the circulating nurse tried to make it seem like it was all my fault. He decided counsel me on "how to be a better scrub nurse" in the middle of surgery in front of all of the surgeons. I told him right away that I am not accepting the blame for the count not being done. I think that instead of assigning blame or using that as an opportunity to "teach me" how to better scrub, we should have been defending each other because we BOTH made the MD aware of the fact that the count hadn't been done. How many times must I tell people that reprimanding me in the middle of surgery is unprofessional and plain old rude. After surgery, pull me aside and tell me what you want me to know. I am approachable.

The second C-section was with a doctor that wanted me to anticipate her needs and differentiate by tone of voice when she is talking to me and when she is talking to the resident. I couldn't do anything right for this doctor. I didn't fold the sponge properly or hand off the suture scissors quick enough and she in the middle of surgery decided to give me immediate feedback regarding my performance. I responded by saying that I was a new nurse with limited scrubbing opportunities and with practice, I will become better at anticipating her needs but in the meantime I need her to be patient and clear about her desires during surgery and I left it at that. She walked out of surgery with a major attitude. Most of my peers would have been bawling their eyes out but I think that these "experienced medical personnel" need to realize that at one point in time they were new and that medical school or nursing school is ineffective at teaching a person everything they need to know about being a doctor or nurse.

DiVa, Experience is the best teacher...

An interesting possible date

2007-06-15T21:47:00.000-04:00

You know I have always kind of been against dating on the job, but this time the DiVa might have to make and exception. I met a really nice guy on the job. The first time I saw him, he was trying to be flirtatious and I was like "whatever" but now I am thinking about it and I am like "maybe". He is not a nurse, nor does he work on my floor. Oh, and he is not a cop which I have been told goes together with nurses like peanut butter and jelly.

He is an electrician, and he is a really handsome. Since it is late and I have to go soon, I will have to log in and tell you more later. In the meantime, any suggestions on what to do next?

DiVa...so bad at this dating thing!

There's just one thing...

2007-06-14T17:22:00.000-04:00

That I cannot seem to wrap my head around. When I find out or have a feeling that people have said something crappy about me or reported some fictitious occurrence that gets me in trouble at work, I cannot smile in their face and act like nothing has happened. I cannot be fake like that. I have always been one of those type of people that can't let someone hurt my feelings repeatedly. You have ONE chance to screw over The DiVa and unless you apologize to my satisfaction, (Or I realize that whatever happened is my fault), you are written off. That's how it has always been.

One night I talked to a senior nurse about what I was feeling and she shared that she feels the same way. But nursing isn't one of those professions where you can alienate people because you don't like them. If it is a code situation you need HELP and alot of it and you cannot pick and choose who comes to help. You may have a room full of your worst adversaries and you have to make it work. It has happened to me before and I know that they went back and reported that I am inept, but I was a brand new nurse to the world, I shouldn't be the expert yet. I am still getting adjusted to this nursing thing.

I know for a fact that I cannot Susan cuss me out in the presence of everyone and then the next day say "I love Susan, she makes the best coffee." I would be more like "F--- Susan, that B---- better be glad I didn't beat her A--!" That is definitely something I need to work on.

I am really pissed off at my cousin this week. I had Tuesday night off and I though that we would hang out and have a cocktail and enjoy the night. I gave her $11 to buy a bottle of our favorite alcoholic drink and told her I would be over by 8-8:30 to hang out. I should have known I couldn't trust her to do the right thing. I get there at 8:30 as promised and her driveway is full of cars. I get in the house she is passed out drunk with a house full of people who had been obviously partying at my expense. I was a little pissed because the bottle that she allegedly bought with my money was EMPTY and sitting on the table. I was cool, I said "Someone owes me $10", and left it at that. Her nephew dragged her drunken behind out of bed. She ignored me and said, "What is she gonna do, beat my ass?"

I am a professional. I don't need to beat anyone's ass. However, I do believe that I am due a bit more respect. It was my idea to hang out. I had brought a movie, I had a babysitter I planned to have a good time. How do I approach her now? This would be a perfect opportunity to learn how to resolve problems and move forward in relationships because all the time I have wasted being mad at my cousin about the stupid crap she pulled this week we could be working on having a more meaningful friendship not that it is too late to do that, but the stuff did happen on Tuesday. If only I could work out situations with the understanding that the offending action would never happen again.

DiVa, trying to learn how to better manage her relationships...

Beware of flying babies, a cautionary tale...

2007-06-13T14:59:00.001-04:00

Have you ever seen a movie where a woman is having a baby and the baby comes flying out of a woman like a cannon ball or something and the doctor is standing right at the end of the bed and catches the baby like a football? This very thing happened a few weeks ago with a patient of mine. Here's the story.

It was a busy night in the delivery rooms and I already had one laboring patient, but she wasn't doing a whole lot so I was assigned an active laboring patient. She was a gravida 2 para 0 and she was 6/90/-2 on her exam. She was 31 weeks pregnant, which is viable (at our facility anything over 23 weeks is viable which I think is crazy but that is another post). The doctors told her that they believed that they could possibly stop her labor because recently we kept a lady at 5 centimeters with a bulging bag for almost two months in a reverse trendelenberg. Not common, but possible. The plan for this patient was to give her Indocin (a medication to stop labor). If that stopped labor good, but if not we were planning to have a baby. So I gave her the Indocin and the Nubain (pain medication that works at the neuromuscular junction to intercept pain impulses) and then the waiting game began.

Her family surrounded her bed and they held hands and prayed. They were pleading with God to stop the labor. It was very nice, and I was hoping that would work because I am not very good at code pink deliveries. After about two hours the pain started again. I had her checked and she was 9 centimeters dilated. She wanted an epidural, but the doctor suggested that she just go at it natural because she was afraid that it would have a negative outcome, but at the same time she told the patient it was her decision. Why didn't she just say no? The patient was begging me to get her an epidural and I knew that Anesthesia wouldn't allow it because she was to far gone. About a half an hour after that we start pushing.

I have a general rule about pushing, I never take the bed apart without a MD being at the foot of the bed. And this time it was for a good reason. As a matter of fact we didn't even take the bed apart, we just lowered the foot of the bed to make it like a chair. So I had the patient begin to push. I called my neonatal resuscitation team and my charge nurse. I also had all the necessary OB doctors at the bedside. My idea was that we do slow controlled pushes so that the baby would glide out gently into the doctors arms and be given to code pink. And we did do a few pushes my way, but the charge nurse had a different idea. She wanted that baby out and she wanted it out NOW! So she told the patient to curl up like she was doing a crunch and push down into her bottom with all her might. She did and after about two pushes the bay came flying out, and if the doctor hadn't been standing at the foot of the bed, that baby would have had airtime. I was mortified. I was speechless for about 10 seconds. Being pleased with the outcome, the charge nurse went over to the warmer to assist code pink and it was business as usual.

DiVa, know when to break the bed and when not. Babies are fast when no one is there to catch them!

Just when I thought I couldn't do something more idiotic...

2007-06-02T16:23:00.000-04:00

I prove myself wrong by doing something ridiculously idiotic. Last night was a busy night and our nurse manager was working alongside of us. This is a cool thing because I love the fact that the manager is willing to roll up her sleeves and come down into the trenches with us. At any rate my patient had a negative blood type. Here's a quick tutorial on Rh negativity and pregnancy.

If the baby has a positive blood type and the mother has a negative blood type, the mother will build antibodies against the baby. Since she was a primipara (having her first baby) nothing bad happens. However with the second pregnancy, if the baby has a positive blood type and the mother has a negative blood type, the mother's immune system will reject the baby. By rejecting, I mean it will attack and kill the baby. So in this particular delivery, it was very important to find out what the baby's blood type is so the next time or even this time, the mother can be treated with Rhogam to prevent a rejection. It desensitizes Mom to the positive blood type baby.

The baby was coming out very slowly, probably because he weighed 9 pounds, but it made me nervous because I wanted at all costs to avoid a forceps or vacuum delivery. I called the charge nurse in for a little support. I was so wrapped up in the safety of the Mom and baby that I totally forgot to collect a sample of the fetal blood. So in my mind I am organizing requests. The doctor is asking for suture to repair the perineum, and then a light and maybe some lidocaine. I wanted to keep an ear out for the babies apgars and such. Oh, and I needed a syringe to draw the blood out of the placenta because I neglected to ask for a section of cord for the blood sample. The clock is ticking because if blood sits still for too long it will clot and then the baby would probably need a blood draw. The doctor asked for a stool.

I went into a room to get a stool and noticed that the manager was taking care of my other patient. I said Hi and returned to my room with a stool and a syringe. I proceed to draw blood up from the placenta. Good, it's not clotted. I take my vacutainer and who walks into the room? The manager. While she is watching me, I take the needle and stick it into the top of the vacutainer. She says, "Aahhh!" I look up but it is too late I have already done a big nursing no-no. What if I had stuck myself with the needle?

DiVa, needs to remember to protect herself at all times...

Coming soon, "Beware of flying babies, a cautionary tale."

I quit smoking...

2007-05-24T12:21:00.000-04:00

Then I start again. Then I quit again. And now I am smoking again. I promised myself that after I saw people in the ICU with all different types of tracheostomies related to smoking for extended periods of time that I wasn't going to be smoking ever again. But somehow, I now find myself with a pack of cigarettes saying, "After this pack I am not going to buy another." Alright, I will do it again, "After this pack I will not be buying anymore cigarrettes.

I have some rules about my smoking. I don't smoke at work, nor do I smoke in the presence of my kids. I believe that my son has an idea that Mom might have an occassional smoke, but he can neither confirm or deny my status with regard to the smoking. I regularly ask myself why and the resounding issue is stress. Besides the fact that I think cigarettes go well with a nice cocktail. There are other ways that I can relieve stress such as exercise, hobbies and journaling but who has time for that? I can easily slip a cigarette into my daily routine. I really must make time for other things.

So the last time I wrote I was thinking about leaving my job. I really have no idea what course of action I want to take with regards to my career. When I think my job is at its worst I have a pretty good day and I realize that this might be what I really want to do. I actually had an interview about a week ago and I haven't heard anything. In my mind, I am prepared to find a way to make this job work. By any means necessary. Most days at work, I feel like public enemy #1. I decided that I don't need to have long lasting relationships with these people, that I only need functional working relationships. Which is marginally unfortunate because I sometimes envy the fact that the other nurses can laugh and talk together and I don't. I also find myself pissed off when I walk into a room and it falls silent. But I am becoming more and more comfortable with my I don't give a damn attitude. I am a DiVa, why do I care anyway? I applied to graduate school last week.

Right now I am re-evaluating my life and the people that I have let into my inner circle. Not that I think that I am better than anyone, but there are a few people in my life who, well...aren't going to amount to anything. And they are dragging me down. And in the midst of that they make me feel like I think I am better than they are because I have a degree. Not the case, because I could end up homeless or on drugs but I have come to far to let some stupid shit like that get in the way of my progress. So to keep myself focused on the task at hand, I have decided to take at least one graduate level class a semester until I have a master's degree. It's good to have a plan and a goal.

DiVa...never on schedule, but always on time.

What am I looking for now?

2007-05-10T15:20:00.000-04:00

I was hanging out with my friends yesterday and they are single. Yesterday was almost like summer. It was a warm lazy day. I called off work to hang out with them and see the city. I and all of my friends are single. I have finally pulled myself away from the relationship with my finace and I think I am ready to meet people again.

My one friend is 30 years old and loves what is known as "the thug." The absolute last thing I need is "Mr. Thug" and his pharmceutical sales occupation interfering with my nursing license. When it comes to love, I think that I need to take my time and wait for a nice young man (no older than maybe 45 and no younger than 35) that is a professional and a perfect gentleman. One who likes/has kids and/or a dogs and has something to bring to a relationship besides emotional baggage. He needs to have his OWN car and his OWN place. No mama's boys allowed. I need someone who has hopes, dreams, goals and is willing to contribute to a healthy loving relationship. He has to be able to understand that a DiVa needs a strong but sensitive man who knows when to stand up to the Diva and when to let a DiVa be a DiVa.

I was told that I looked very cute yesterday. I agree. This weekend, after I spend mother's day with my children, I am supposed to attend a male revue. I don't particularly care for these sort of events, but it's a night with the girls, what can I do? Perhaps afterwards, we will go to a greasy spoon and there will be a tall, dark and handsome stranger drinking a cup of coffee. He will see me and have to know more about the DiVa. Hell, not in this city...

DiVa, not really looking at all but wants to have an interesting summer...

Proud to be a nurse...

2007-05-07T20:49:00.000-04:00

This morning after working my 12 hour night shift, I went to my appointment with my therapist. Yes, I have no shame in admitting that I see a psychologist. I told him that I would meet him at 8:30, but I got there over 20 minutes early. (Yes, the DiVa was not fashionably late.) I fell asleep in the parking lot.

All this week I had been planning to drop my therapist because I felt that we had surpassed the therapuetic phase of our relationship. It had got to the point where he was like saying things in a suggestive way like, "Are you sure your insurance won't cover my full fee?" or "If you are going to stay in a bad situation just because the money is good, then accept it for what it is and get over it." It seems a bit harsh to me because I favor the Gestalt method of psychotherapy. I digress.

I was awakened by the knock of my therapist on my car window. It was a startling awakening, but I recovered and followed him into his builiding. I see a therapist who practices in a rural area. The trees were blossoming and the sun was shining. I must admit this morning was beautiful. So he asked me how things have been going. The topic of today's session was my job. I have spent a great deal of time weighing out the pros and cons of me staying at this job.

The cons
The lousy hours, the atrocious scheduling practices, the issue of seniority and its impact on practically every aspect of the job. I will have to work nights or evenings at least another five years unless someone dies or quits. In five years my son will be 17 years old which is too long to wait for a change. I need to spend time with him NOW. The bitchy nurses that I work with has been something I have grown accustomed to and I must say I have learned how to handle the doctors that seem to have a vendetta against me from time to time equally as well. But the number one reason why I feel that I really need to leave my job is that I can't stand to watch my daughter cry when they call me in to work on my days off. Or the look of disappointment on my son's face when he realizes that yet again, I have to work every weekend. And the fact that on most holidays I will not be home.

The pros
Yes there are pros! are that I love being a labor and delivery nurse. My job allows me to bring people together. Despite all, birthing is a collaberative and emotional process. I love being a part of peoples lives at such a special time in such a personal way. I am proud to represent my demographic in a hospital where the staff somewhat frowns against the unwed mother. I am not ashamed of being and unwed mother, a product of the welfare system that was able to turn my life around with strong will and determination. I love our patient population. I have the power to take the meanest uncooperative patient and make them warm and gracious. I love it. I love the human connection and I will miss it.

I almost hate it that I will have to walk away from this job soon, but I love my children too much to neglect them any more than I had to when I was in nursing school. I promised myself I would never do it again. So I have decided to start looking for jobs again. Surprisingly, my therapist supported me in my decision. My mother is indifferent. My kids can't wait for me to quit. And I am conflicted. But more than anything, I am proud to be a part of a profession where compassion is a requirement.

Best,

DiVa

Why can't I sleep?

2007-04-29T16:23:00.000-04:00

I'll tell you why, it's a beautiful day. The sun is shining, the birds are chirping and I am going in to work for my 3rd twelve out of four straight twelve hour shifts in a row. I want to sleep, but spring is beckoning me out of my bedroom window, glowing through my room darkening blinds. New life is on the horizon, and I am at the helm.

Last night I learned how to cover my butt so to speak. I was in the back, all by myself with a lady who was a grand multiparous (G6,P5) precipatous deliverer of babies. Being that I work in what is know as a teaching hospital, we have residents in various levels of training. This one particular resident was a family practice resident, which means that she does obstetrics for fun and not as a specialty. It is not her primary discipline, she provides a potpourri of services to her clients. Anywho, my patient was 6 centimeters dilated, 90 percent effaced and at a -1 station. She was huffing, puffing and used to having babies with no anesthesia. The family practice resident and attending came by to get her checked in and left me to manage her labor. As always I told them not to go to far because I had a feeling that this lady was gonna go really fast.

I received the patient at 8:50 pm. At around 9:25 pm that she felt like she had to have a bowel movement. I told her absolutely not and I explained that she could very well deliver the baby while it was still encapsulated in the bag of waters. Fishing a baby out of the toilet is not my idea of a good time. I explained that I would rather her poop in the bedpan and clean up the mess. She wasn't exactly pleased with the idea, but went along as she realized I was not going to give her any other option. As a precautionary measure I had the family practice resident and attending paged to assess her pressure because I just knew this lady was going to deliver any minute. At 9:30pm her water broke. At 9:35 the resident showed up she only had enough time to get sterile gloves on and say the patient was completely dilated. I covered my patient who was sitting in a pool of amniotic fluid and poop with a sheet and began to assemble supplies.

The patient was involuntarily pushing and I could not remove the soiled linen. I ran to the intercom and called for any attending physician and our charge nurse to come to my room for the delivery. Before I could hang up the phone good the baby's head was out. I swear, the attending peeked around the corner, saw that it was family practice and turned around and left. My charge nurse never showed up.

My delivery resident doctor said something cute like, "I've never done this before." I was thinking "Oh shit, I don't really know what to tell you to do. But hey, I have seen it done a million times. Here goes." I pulled the delivery cart over to the bedside. We placed the baby on the Mom's abdomen. She clamped and cut the cord. I told her to do some fundal massage and wait for the placenta to loosen. In the meantime I took the baby over to the warmer and worked on him. He was stable which freed me up to do other things.

She was kind of holding the cut end of the remaining umbilical cord and when she felt the placenta loosen she had the patient push it out. I started the pitocin to clamp down the uterus. I was doing like 5 things at once, pushing medication, doing apgars, assessing baby and mom when finally the charge nurse and attending came around the corner. Everything was already done. Then about ten minutes after all that, the family practice attending came. For a moment, I finally felt like a real nurse. I handled that delivery like a seasoned professional nurse. Or at least I thought.

The attending had a problem with my performance at the bedside. She felt that I should have called her sooner. I don't know how I could have done that, but she failed to realize that I was in the room when she told the resident that saw the patient involuntarily pushing on the EFM at the nurses station and decided not to come in to help. She must not have noticed that I saw her shoes under the curtain and her head peeking in to see what we were doing while we were getting the baby delivered. I imagine that this is going to turn into another episode in the nurse manager's office. But I don't care because I am a NurseDiva dammit! Oh yes, I'm still that bitch and I haven't forgot how to get nasty when I need to. Wish me luck!

DiVa...gettin' down and dirty when she needs to!

I think being a nurse has made me a lunatic!

2007-04-26T15:15:00.000-04:00

I can't really describe what is going on with me, but I know I am not alone in my condition. There are other people who are suffering along with me, the only difference is that I have no problem putting myself on blast. This morning, one of the other new nurses confided in me about her situation on the floor. She isn't even out of orientation yet and they have already told her she is not going to make it. I feel bad for her because I know what it is like to be under their scrutiny and criticism. There is no way to please the "senior nurses" who have only been nurses less than 3 years themselves. Nursing can be a very tough job. you have to be a high riding bitch because your kindness will be easily mistaken for weakness. Thank God I have finally become in tune with my inner bitch.

Anyway, I have mixed emotions about my job. First of all, our hospital pays one of the lowest salaries ever. Given that, I worked there because I felt that I would get the best nursing experience because of the high acuity level of the patients. And this is true, I am getting really great experiences. However, given the nature of our unit, many people who started the same time as myself have quit. Even I have debated about quitting. Not even a few days ago, I wrote an entry about how I planned to stick it out and about two days later I applied for a new job. And the crazy thing is that the new job would entail me following the very people that I was trying to get away from. Crazy isn't it?

I don't know what is wrong with me. In one breathe, I am tired of working the night shift. But at the same time, God is answering my prayers by moving all of my enemies out of my way and making the job so much more tolerable. People are becoming increasingly more friendly. The stress level is decreasing. Teamwork and morale is on an upward trend. My schedule is getting worse because we are understaffed. I am seriously becoming bipolar. I go from one extreme to the next. I am elated because my skills are improving and I am really beginning to know what I am doing, but I am becoming more depressed because summer is coming and I HAVE to sleep all day. I signed on to work three twelve hour shifts, but rarely do so because business needs require me to work more hours. I wanted to get another job working PRN "nursing for dollars" and I have no time.

My dream of buying a new house is getting further and further away. I am spending my time right now trying to rebound from the financial pit that I am in as a result of nursing school. I am trying to get used to the student loan payment. I have tonight off, but it doesn't even really feel like a night off because I am off in the night time, not the during the day and tomorrow, I begin a stretch of four twelves in a row, and none of it is overtime because it is stretched over two pay periods. (How sneaky!) And most of the time I don't feel like I truly have a day off because I am on call. I refuse to take overtime because I want to have at least a few days off in a row and besides, I am on call, so I will be there anyway. And what difference does it make if they hire new people, they are just going to quit in a few weeks anyway. The funny thing is that when I was hired, my boss said that turnover is low and that people have been there over 20 years. In the time I have been there 9 new people have quit. I may make it 10...

DiVa...seriously losing her mind, seriously!

Finally, a moment to blog!

2007-04-20T14:10:00.000-04:00

It has certainly been a very long time, hasn't it?

I am still a labor and delivery nurse. Somehow I found a way to hang in and make this job work. It's funny, I have almost been a bonafide RN for just about a year and I've come a long way baby.

Since the last time I stopped in to drop a line, a few things have happened. Most importantly, I found my voice. One night a doctor decided that she would dress me down in front of a patient. I waited until we left the patient's room and told the doctor exactly how I felt about her attempt to make me look like a complete idiot in front of the patient. I advised her never to do it again and in the future she should treat nurses the way that she would like to be treated. I guess I surprised the crap out of everyone because for the rest of my shift, no one said anything to me. Not one word. But now, people nurses and doctors alike give me just a little bit more respect than before. Interesting. So all I had to do was act like I was going to kick some butt and people change their tune.

A few of the other new grads have come out of orientation. I realize that there has to be someone to pick on or work just isn't fun. I am glad that it isn't me anymore and also sad that we can't treat each other just a little better. Just a few nights ago, I heard a few of the nurses discussing a new nurses performance and just how stupid they thought the person was and it was at that moment I realized that this must have been the way they talked about me. Hmmm. So they don't particularly care for nurses who are trying to be therapeutic. I guess it can go overboard a bit like begging a patient to move their feet or lift their butt one hour after having their belly sliced open but I can say that I don't blame the patient for not wanting to move in the first place. It is much better appreciated to get a patient out of the unit as quickly as possible.

It is also pretty funny that two of the same people who suggested that I give the unit at least a year have left our unit to pursue new opportunities in other areas of nursing. I am pretty glad that I decided to tough it out. Things are getting a lot better. My kids still don't like it that I have to work so much, but they LOVE being able to do the things that my new job affords us. And they are also looking forward to me buying a new house. Yes. I have been looking at houses and I am working on making an offer. According to my realtor, I could possibly be moving in to my new home in the next two months. The new mortgage is a lot more than the old one. But I will get used to it.

Time to start getting ready for work. I promise to blog more often!

DiVa....quite the nurse extraordinaire!

Happy Valentine's Day

2007-02-14T20:35:00.000-05:00

Hey guys!

I am sitting at home with my kids, listening to love songs from the eighties and nineties. They think that music from my youth is good, which is surprising! They think the videos are hilarious. I think their music is pretty weird, and their videos make me blush. Ah, the generation gap. We are debating what we are going to have for dinner. Kinda hard to think about food when the dog keeps pooping in the dining room.

My kids are the most beautiful gift that I have received in all my life. I have been thinking about it more so since I have been taking care of this patient that is pretty close to my age. She is pregnant and she has a brain tumor. It is pretty scary to imagine that once she delivers her baby and has her tumor removed there is a possibility that she may never see her kids again. And like Anna Nicole, she will have died before her baby son will ever remember the sound of her voice.

Okay, I realize that was a huge downer. So I will talk about some more positive stuff. Like the fact that I am learning that I am more normal than I thought. I talked to my charge nurse about challenges I face on the job and she said some really reassuring things. I decided to turn down some the job offers that were extended to me recently. Mainly because I need to make this job work. I can do it.

I am still planning for our vacation starting this weekend. I am trying to find clothes and swimsuits and such. Then I am deciding what to pack. It's 84 degrees there. I guess I will have to pack just in case. Then I am debating on whether or not I am going to cook while I am there or buy food. I am on vacation. I am not cooking. I am going to relax in a hot tub and enjoy my time off and my family. Then I need to get the oil change. I don't have that much time off, but I've got to make it count. Alright, time to get back to the kids. I hope you guys had a great evening with your families.

DiVa...Lovin' on her babies, because tomorrow isn't promised.

Finally, I am planning a vacation...

2007-02-02T10:27:00.000-05:00

The kids and I are taking a vacation. A much deserved break. We are going to an amusement park since I only have a weekend. I am almost excited myself even though there are limited activities for adults. I will enjoy watching the kids have fun. And besides that they had awesome report cards this last marking period. I hope they will forget that I promised them I-pods in exchange for good grades. Not likely.

As far as the job is concerned, I have started looking for other positions at different hospitals. Not because I am seriously going to leave my present position, but because I need to feel like I have value. Also I need to have a feeling of control over my life. Like I have a choice about how I am going to live out my career as a nurse. I have already been on two interviews and one of the hospitals was trying to hire me before I left the unit. I will be accepting a PRN position just to see how the other half lives. You know,to compare and contrast county hospital versus community hospital.

The one position that I interviewed for is as an OR nurse. My primary responsibilities would be to scrub and circulate. My two great loves. It is day shift, 10 hours a day and 4 days a week. I can get any holiday I want because it is not based on seniority. The down point however is that I have no contact with my patients and I do not get to use ANY of my skills. I have worked too hard and I am too good at the skills aspect of my job to give that up and so I will probably pass on that position. The other position is in a labor and delivery unit. Compared to our unit, it is utopia. Everything is brand new and state-of-the-art. It is also night shift, which sucks, either PRN or part-time neither of which is attractive to my current life situation. But since we will be losing our overtime possibilities due to recent new hires, it is a good fit.

I must admit, I do feel more valued having examined my options. And it has increased my confidence at work as well because I have skills that are highly sought after. I am going to stay at this job just because people don't think I can. I guess I am just goofy like that, but I can't let this situation beat me. My clinical decision making skills are improving every day. And as far as making friends and playing nice with others, I don't care about those bitches one way or the other. I mean, if they are doing something and I want to be a part of it I will participate, but otherwise screw 'em!

My bills are getting paid off and my credit is improving by the minute. I am getting my life together, which was the point of me going to school in the first place. I finally feel like I am making some positive strides. Now to get this house cleaned up. I had hired my cousin, who I have written about a few times before to help me get my house cleaned up. I thought I was doing something nice because she has had a few tough breaks in life and I thought that it would be a way of helping her get back on her feet. I thought it would be a nice thing to do because in my life, a few people helped me out when I was down on my luck and so I should give back. I let this bitch in my house for one hour and before I could get her home good, I recovered at least 10 items that she stole from me, and I paid her pretty well. In addition to that, she didn't even finish the job. She wanted to come back and I told her to take a flying leap. Burn me once, shame on you. Burn me twice, shame on me. She is officially on my shit list. In 2007, the Diva ain't taking shit from NOBODY, never!

DiVa...Finally feeling positive for a change!

This job is making me crazy!

2007-01-21T06:57:00.000-05:00

I hate feeling like this. One day I am thinking, okay I have a handle on this job and the next day I am a complete moron. It is becoming more than I can bear. Even as a DiVa!

The past week, everything I try to do well ends up being a fiasco. I had a patient who was having all these late decelerations. On a fetal tracing, a late deceleration is when the baby's heart rate takes a dip right after the peak of a contraction. Lates are not usually a good thing as they are indicative of cord compression. If the umbilical cord is compressed the baby is not getting much oxygen. IF this low oxygen state persists, the baby can become acidotic and generally a speedy deliver, usually a c-section is indicated.

In my first bad delivery, the patient was having these late decelerations and we began to push because at this time she was completely dilated and effaced. The baby came out with the umbilical cord wrapped around his neck twice, tight. The cord could not be reduced it was so tight. The MD clamped and cut the cord and I tried to stimulate the baby to breathe on the Mom's chest. That didn't work. So I too the baby over to the warmer. I had my warmer set up and someone messed with the suction. It wasn't working. My baby was not breathing. So I checked the heartrate. I was over 100 which is great.

So I used the bulb syringe and continued to suction and stimulate. I wasn't even thinking about the code button. The OB attending asked me if I needed her to get me some help and I said PLEASE! So the two snobbiest, bitchiest nurses on our shift came into my room. They asked me what I was doing and I told them and they said "Why don't you just go take care of the Mom. We've got this." They were so nasty. It really hurt my feelings. I decided not to say anything because I know that I am the unit moron. These people always have a way of putting me in my new grad, don't know nothing about nothing place. I wonder if they came onto the floor knowing everything there is to know about being a nurse.

Then a day or two later, I had a mom with twins. She was over 40 weeks which is amazing for twins. Everything started off well. I was working with another inexperienced nurse and she was questioning everything she asked me to help her with like I didn't know what I was talking about. And she was double checking my answers with two other new nurses. Amazing! I should have stopped helping her but as I see it, nursing is a team sport, and there is no "I" in team. But besides that, I am trying to be the type of nurse that is helpful and not hurtful. Whatever. My twins had started having late decelerations. I had been calling all night because the tracing had begun to look a bit questionable. However, it didn't stop the MDs from calling me and asking me to increase the pitocin.

Anyway, I had been turning her and gave her some oxygen. I called overhead after two really moderate lates and the charge nurse comes over to ask me what I am doing. I was reviewing the tracing with the doctor, but I guess that wasn't good enough. I went into the room and turned the patient I gave her some oxygen, gave her a bolus of maintenance fluid, turned off the pitocin and looked for a change in the tracing. In the meantime, another nurse came in with the anesthesiologist. She was yelling at him that her blood pressure was too low. It wasn't too low. As a matter of fact the blood pressure wasn't very different from her baseline. The MD wanted to place a fetal scalp electrode. I had my monitor parts. By this time my room was full of people. The family was freaking out. Then the two evil nurses from my other delivery come in and start whispering. I am about ready to cuss, but being the DiVa I am, I stayed cool. The heartrate looked good, the babies were on the monitor and one by one the intervention was being to dissolve. Normalcy returns. And I am back at the monitor, charting and watching my tracing.

At this point I am mad as hell. I am about ready to quit this job. I am trying so hard to be part of the group. They had a party and I made something to share. No one ate it. I guess that's okay because I brought it back home and it was gone by the afternoon. But at the same time, It hurt my feelings. I talked to the nurse manager and she asked that I hang in there and just wait to see how much I really know. I don't know if I can. I have already started putting in applications at other hospitals.

DiVa...Using the nursing shortage to her advantage. I don't have to feel uncomfortable anywhere, Bitches!

All of a sudden...

2007-01-16T19:51:00.000-05:00

Things are starting to come together. I feel like I am starting to know what to do and when to do it. I won't get too excited, but it is pretty amazing. I am becoming more proficient at deliveries than ever before. And I am pretty good in the OR too! I am finding that I really am enjoying the OR more than ever before. I am even thinking about finding a PRN position as a scrub nurse or circulator. Baby steps, DiVa! Baby steps...

I don't know what happened. I am pretty happy about it though. I wish I had more experience as the screening room nurse, but as I understand it my experiences as a labor and delivery nurse will make my screening experience much better. I can't wait. I think that one of the most frustrating things about being a new nurse is that I am dying to be therapeutic, but it is impossible to be therapeutic when you are still trying to develop your basic nursing skills in your area of interest. Once the basic skills come together then it is easier to incorporate other skills and specialized language training and so on. I can't wait to see how much better I will be six months out.

I think I am finally being socialized into my work environment. It is hard coming onto a floor that has already established relationships and bonds. I am finding that I work with a really awesome group of women and a few men too. I am not a part of any particular clique. I don't really have the time to be a part of a clique because I spend most of my time in the room with my patients. And working with doctors is getting easier too. At first I was afraid to express my opinions or question orders. But now I can question an order and express how I thing the plan of care can be better managed. I can even make a suggestion or two. Funny, huh?

My son recently showed me a pile of papers that he had graded. Most of them were perfect papers. I was impressed. My daughter is becoming so responsible. I am almost obligated to buy her these darned heelys that she wants so bad. And the puppy, he peed on the puppy pad in the bathroom all by himself. Without me taking him into the bathroom. Amazing! I don't know what I am doing right, but for the moment everything is cool.

DiVa,...Confidence is my middle name!

Is it really all about me? A moment of reflection and mediation...

2007-01-11T11:16:00.000-05:00

I was always taught that being selfish is a bad thing. Is it really? Is it so wrong to care a little bit more about yourself than anyone else? I think sometimes it is okay to be selfish, but where do you draw the line? It may seem a bit conceited, but how could I possibly be a DiVa if I didn't think I'm all that?

At this moment I am doing a little bit of reflection on myself. I have to take a little time for myself, otherwise I would go crazy. The kids are at school. It is quiet. I have to give myself the daily pep talk to get through another night of work. I have to remind myself of all of my talents, all the things that got me where I am today. Hard work. Persistence. Creativity. Intelligence. Yes...

Breathe, slow and deep. In through your nose, out through your mouth. This shit is not working. Dammit! Try again. Don't let that negative inner dialogue take control. Yet another exasperated sigh. I can't do this. Yes, you can. You are so blessed. At least you are alive. You are breathing. Breathing is the one effortless act that even a newborn baby can do. Focus on your breathing.

What the Hell? How can I focus on my breathing? I need to cook dinner, but I can't because first I need to wash dishes, dishes that have been sitting so long that a colony of fruit flies are hovering around any time someone walks past the sink. The dog is taking a crap on the rug or pissing. Which is worse? Both. There is a pile of clean and dirty clothes mixed together in my kids room, in a basket which happens to be spilling over onto the floor. The must be re-washed. Get the bucket, scrub the soil from the carpet. Clean the crate insert puppy. What else is troubling you dear? Interest and late fees are accruing. Those damned student loan payments have started and I am freakin' scared and overwhelmed.

Scared that I will never get adjusted to being a real nurse. Concerned that my children are still not getting what they need from their mother. Overwhelmed by the amount of catching up that needs to be done in order to get my credit and household together. Depressed because this seasonal affect disorder has me all out of wack. Tired because working night shift has my sleep cycle all confused. Worried that I will never be adjusted enough to return to school to get that Master's like I had planned. Pissed off that this hormone impregnated IUD has my skin all broke out like a teenager. Discouraged that I will always be at least 5 million pounds overweight no matter what I eat and how much I exercise. When will I ever be normal???

I am going to be normal right now. I'm getting out of bed and I am going to quit wallowing in self pity. I'll clean up a bit so that my babysitter won't be repulsed by my filth. Then, I am going to run a bubble bath and use one of the over 20 bottles of products that I purchased at the semi-annual sale. Even if I feel rotten, I will smell like a flower or piece of fruit of something. I am going to wash my hair. Hmph, at least I will have shiny hair even if I am a bit crabby.

DiVa...One day at a time!

You know you have a good job when...

2007-01-06T05:45:00.000-05:00

Your boss babysits your kids for you when you current ex-fiance decides to teach you a lesson by quitting watching the kids only hours before you are scheduled to be at work.

I love my boss. I had a fight with my ex-fiance, who had been helping me out with the kids on a probationary basis to see if we could get our relationship back together. He got mad because I asked him to keep up with the maintenance on the car he was driving and gave him until the end of the month to get the repairs done or else the car gets parked. My punishment? No more watching the kids while I work. A gravy job if I do say so myself. Since I work nights, I only needed someone to watch my children sleep.

The even more screwed up part is that these are HIS kids and even his mother refused to help me. I guess when he gets mad, so does his entire family. No more second, or third or forth chances for this bastard. This time I can make it on my own. I am not worried, or afraid of what anyone thinks about this situation. I am moving forward with my head up and my pride intact. I have a lot of work to do. It's a good think that I have a good relationship with my ex-husband.

I had found someone to watch my children the day I had to be at work. My ex-husband could watch them for one day only. My mother was out of town and I needed help for the next two days of work until she returned to town. So I called my boss and asked her if they could sleep in the nursing lounge until the end of my shift. She said no. I asked if I could adjust my hours so I could be home to put my kids on the bus. She said no, but then asked how old my children are. I told her their ages and she said she would watch them. I was shocked. At first I thought to myself, I can't let MY BOSS watch my kids. But then I thought I could get enough attendance penalty points that I could lose my job. That would really suck. So I let her watch them.

At first I thought that she probably didn't want the whole floor to know that she was doing me this favor, so I hid my children in the conference room. But everyone knew that she was doing this for me, so I brought them out of the conference room. Everyone wanted to know how I got her to do it. I didn't do anything special, she just offered to do it. I got the kids bathed, fed them dinner and brought them to work in their pajamas. My boss has two little boys that are toddlers. They are very cute. I thought that it might be too much work. I threatened to kill my kids if the misbehaved, kissed them and sent them on their way.

My boss took my kids to her house. She hung out with my kids. She shared stories of her life and pictures of her travels. She put my kids to bed and when they were scared of the dark, she came in the room and addressed their fears. In the middle of the night! My boss woke them up, fed them breakfast, got them dressed and brought them to my job at the end of my shift. If their clothes were wrinkled from being folded and in their bookbag, she ironed them. I was in tears. She doesn't know anything about me, I didn't even go into details about why I had no one to watch my kids and she jumped in and helped as if I was part of her family. On a voluntary basis for TWO DAYS in a row! I will probably never quit my job.

DiVa... a young nurse who learned a huge lesson about how God works! I still can't believe it.

Happy New Year!

2007-01-01T19:41:00.000-05:00

As a student nurse I couldn't wait for 2006 to arrive. Now 2006 has come and gone. I am looking forward to all the surprises and possibilities that 2007 has to offer. To all of my readers, the regulars and those who happen to stop by on a whim, I wish you peace and prosperity.

As far as my resolutions go this year, I plan to live healthier. I want to spend more time with my children and set boundaries in all of my relationships. I plan to work on my spirituality. I hope to be a better nurse and humanitarian. Most importantly, I've gotta potty train this puppy so he is not pooping and peeing all over the house!

God Bless,

DiVa...This is the last year I am making these resolutions!

Merry Christmas and all that jazz!

2006-12-27T11:40:00.000-05:00

It's been a long time, I have been meaning to drop in and write a few lines but I have been giving all of my focus and dedication to being the best damn labor and delivery nurse to ever grace cyberspace. To A.H. and all my other loyal readers, here's what's happening in Diva's world.

Job Update
So far, no more bad news about my performance, knocking on wood! The big bosses had promised me around Thanksgiving time that I would be observed for five weeks to see if they could find out what my learning curve is. This is week 4 and I have yet to have a visit from the big bosses. I guess I must be doing okay. Especially since they have the nerve to schedule me to work overtime for three weeks in a row. I would be surprised to find a full term pregnant female in the city! And if you are trying to get pregnant be careful! People are having twins like there is no tomorrow.

I guess that I wasn't the only person who was having a hard time. Another new nurse quit after only working on the unit for 5 months. It is such a sad thing that nurses are not more open with one another about their weaknesses. I don't care if anyone knows that I don't know something. I feel that it is a learning opportunity for me and a teaching opportunity for others, the whole nursing cycle is complete. But that isn't the case. I feel like all of my positive attributes such as kindness, sensitivity, sharing and empathy are all good for dealing with patients, but bad when dealing with nursing peers. These bitches take my kindness for weakness. That day is over. I am about to bring my "innerbitch" to work and stop leaving her in the car!

The way I see it, they can't afford for me to quit because we have been slammed. And in addition to that, many people have quit that have been around for a long time. Makes me wonder what I have gotten myself into, but trust I am enduring. I spend all of my spare time memorizing the floor nursing manuals. I will know every protocol backwards and forwards and dare someone to mess with me! I double dare them! The transition from student nurse to real nurse is a slow and difficult process.

Family Update
Since I have started working, I haven't been spending any quality time with my children. Napping with them after school doesn't really count in my book. The man in my life and I pass each other at the door. I only see him on my off days and those are few and far between when I am working 48-52 hours a week. I was scheduled to work all the holidays. But I received a holiday blessing. When I arrived to work on x-mas morning, I was sent back home because I was not needed. My children were so happy. I baked cakes, wrapped gifts and spent time with my family. It was awesome.

My children got everything they asked for and I got what I wanted too. The only thing I wanted was to spend some time with my children. I thought that becoming a nurse would entitle me to spend time with my kids. And I do, I just have to budget my time better.

Well, I guess I had better take a nap before time for me to go to work. I promise to come back and share more often now that I have my performance issues under control.

Besitos y Abrazos,

NurseDiVa...Improving her performance, one delivery at a time!

Post-Thanksgiving Blues

2006-11-29T08:28:00.000-05:00

I try my best not to write doom and gloom, doom and gloom. It is very difficult to accomplish this as a new nurse. The old adage "Nurses eat their young" is true. Some more than others, but they all eat their young. As always I share the good and the bad, it just happens that right now all I have is bad. Sorry!

Work
I felt like I had become the office gossip, ya know, regarding my mistakes and all so I was proactive and called a meeting with my big bosses and the nurse specialist over our area. Perhaps it seems a bit extreme, but I felt that if my actions were reckless and had a potential to harm patients that I should be the first to acknowledge a learning deficit. Before all that I spoke to the wonderful nurse who oriented me. She was insightful, but it is obvious that she feels no responsibility for any of my "problems" post-orientation. And so she shouldn't. Everyone makes mistakes. Sometimes the same mistake, just different scenarios. I swear these oversights are not intentional.

Speaking to the big bosses was very interesting. Based on the complaints, I knew exactly who came forward about me. I always had a sneaking suspicion about a few of my co-workers. I am mostly disappointed that instead of guiding me in the right direction, that they would automatically go the manager and report me, but not before discussing my actions among themselves and casting strange looks in my direction. In listening to my errors, none of them caused any serious harm. It was the "But what if?" In their defense, I take offense to criticism about my performance, especially if someone is questioning my skills as a nurse. Even though I feel that the intervention is supposed to be helpful, I can't help but feel that it is somewhat punitive. Whatever...

So now what do I do? Pretend like I enjoy going to work when clearly, I hate going in because now I have everyone, (even the other new nurses who were in orientation the same time as me), watching me? The last time that I went to work, I was so freaked out I performed my post surgical count so many times I scared the doctors. (That was not my intention, but God forbid another bad report come back on me or worse yet a sponge...I won't even go there.) I have a promise from a very senior nurse that she will help me get through this, I hope that she can, because right now I don't feel very confident.

Home
Thanksgiving was great. I probably gained back a few of those pounds that I lost. We had plenty of turkey. I did alot of baking this holiday and everything came out perfect. I made this chocolate cake with vanilla icing that everyone ate before my brother had a chance to get any. And my little niece loved my macaroni and cheese. I realized that this whole problem with work doesn't mean I can't do anything right. And it was very nice to have the support of my family. It made me feel alot better.

We have a new puppy. He is a Yorkshire terrier. We are still trying to name our little guy. We were thinking on maybe Baxter, or Santana or maybe even Mosley. I kind of liked Diesel, but what do I know? He is adorable. And so smart. Right now our big challenge is potty training the little guy. I am realizing that this whole puppy business is just like having a new baby in the house. My cat doesn't appreciate the little guy, but he is slowly warming up. He has his days and nights mixed up. Right now, he is on my night shift schedule. And that kind of works! For me anyway.

The children are fine, the house is still a mess. And I feel like I am missing out on everything. Working nights has me sleeping all day and working all night. I think I like working 8 hour nights shifts as opposed to 12 hours night shifts. And then with all the added stress of work, I have no patience for my children. I really need to work on that. Alright, time to pay bills and wash uniforms for another night of birthin' babies!

DiVa...In the valley of her nursing inexperience but will emerge a NurseDiVa before giving up!

How do they know...?

2006-11-15T19:22:00.000-05:00

A few of my colleagues at the job seem to know that I am having a bit of a struggle with my new role as a OB/L&D nurse. Have they found my blog? I imagine not. Cyberspace is a huge place, right? Or maybe I shouldn't talk to my other newbie nurses about my insecurities and feeling just overwhelmed. They are just awesome, they never make any mistakes or forget anything. They always leave on time. They are just so organized. Or are they? I cracked the code on how everyone else manages to leave on time. Wow, I feel alone. I am not part of the clique. It is possible that those particular nurses have an understanding. Or maybe, everyone is in the same proverbial boat as I am in the role of the new grad. I am hoping that the latter is the case.

I must be the only person willing to acknowledge my feelings of inadequacy. Is it such a bad thing? Should I put on the poker face and just go about as though I know everything? I was taught that behaving that way is the most unsafe way to practice. Or maybe I should be bitchy all the time like some of my other peers. Nah, not me. I will need more time to figure out the relationship between myself and other nurses. I am becoming more comfortable with the whole nurse-doctor relationship. They are regular people. I guess I knew that, I just felt intimidated. I have a raging headache, and I don't even have to work tonight. Sigh...

DiVa...Is it really going to take a year for me to feel like I know what I am doing? I can't wait that long!

Inside the mind of this adorable cat...

2006-11-10T10:59:00.000-05:00

Lurks a vicious killer!
The other morning, my daughter was waiting for the bus and she happened to see the cat carrying something in his mouth. It was a mouse, still alive trying its best to wriggle its way out of trouble. My daughter said she asked the cat what he was doing and before she could finish her sentence the cat snapped the mouse into three pieces. I heard my daughter scream and I opened the front door. She was standing there and the cat with sitting next to her looking as if he was expecting to be praised. I patted him on the head and he proceeding to bat the pieces of dead mouse around as if he was playing soccer.

For some reason, I expected him to eat it but obviously I watch too many cartoons. I feed this cat as if he were a member of the family, why on earth would he need to eat a mouse?

I'm not giving up dammit!

2006-11-06T17:16:00.000-05:00

I wished that I could tell you that I am in love with my job or glowing stories of how nursing has changed my life. I will say that nursing has changed my life, but the in love with my job part is a "work in progress." I liken this whole experience to when I had my son, who was my first baby and is now 12 years old. When they handed me my baby in the delivery room I expected this immediate, glowing maternal moment like on television. That happened, but not right away.

As the oldest of five children, I figured that this motherhood thing was a piece of cake because I had been taking care of babies since I was eight years old. I was happy about being pregnant and the thought of labor terrified me because I had no idea what to expect. As soon as the doctors said "Mother see your son...?" I had this realization that this tiny little baby I held in my hands relied upon me to protect him and nourish him. I was all he had in this world. It was a bit frightening. I took him home from the hospital after one postpartum day and on the third day his father was holding him. I was thinking, "Ah, now I can go take a shower." I was gathering my things and I happened to notice that his father was wacking my baby on the back. HARD. I asked what was going on and he said the baby was choking on something. I snatched my baby from his fathers arms and the baby was purple. He was not breathing.

I don't remember how I had the calm to do this but I took the bulb syringe that was conveniently sitting on my night stand, plugged one of the babies nostrils with my finger, pushed the plunger and placed syringe into the unplugged nostril and released the plunger. Nothing happened. So I did it again and felt resistance. When I withdrew the syringe, there was a huge green booger stuck to the end of it. Almost as soon as that happened, my baby turned pink again and was crying. Then I freaked out and called the doctors office. I was crying and rocking my baby in my arms. Even though I started out my motherhood experience indifferent, if my baby had died that day I probably would have died with him.

Nursing is the same way. I had this expectation that I would have this Florence Nightengale experience. Nursing is so much more than that. It is a huge responsibility, like my newborn son. And at any time a situation can happen. I only hope I remember to do CPR!

Men are Stupid...

2006-11-04T16:23:00.000-05:00

Lately, I have been having troubles with my FOB, (father of baby). My ex-husband is fantastic, but my ex-fiance leaves much to be desired. When I graduated from nursing school he became very jealous of my achievements, so he tried to make my life difficult. Long story short he left, I asked him back because I thought that we could work things out and now he has reverted to jack-ass mode yet again. Why won't I ever learn not to trust him when he says he has changed?

The most dishonorable thing about this man is that he uses God and his "spirituality" to make himself seem like this really great guy. To his family, I am the cunning little bitch who tricked him into supporting me as I went to school and better myself only to leave him with nothing. He does nothing to change that perception. As matter of fact, it is this perception that enables him to play me and then play his mother into letting him move back home and save his money instead of being responsible. I am so glad that I never discontinued my order of support because then I wouldn't receive anything at all to supplement my income. One would think that I wouldn't need child support monies, but I have these student loans to pay and it gives me extra money to save for a rainy day.

Anywho, I have devised a plan to get him out of my house for good. It isn't anything crazy, I would just have to try to work a little overtime and set up a strict visitation schedule so that he isn't able to trick me into letting him back into my life. I would also have to amend my work schedule which I am almost positive would take about a year. In a way I feel angry with myself for letting my guard down. I will be fine, but somehow I feel that he should have to suffer and struggle the same way that I have had to for so many years. In a way I was left with no choice because I didn't have anyone to watch my kids while I work. My mother, (who was recently declared cancer-free after her breast biopsy a few weeks ago), has health issues and I wouldn't think of giving her the added stress and responsibility of my children.

Speaking of my mother, we had a huge celebration the two of us on Friday. I am so glad that she doesn't have cancer. I thought we were going to be in trouble. But when her doctor turned the corner and gave us the news we couldn't get out of that doctor's office fast enough. My Dad was supposed to go with her to the doctor's office but when I called and invited myself to go, he dropped out. He is yet another man who is acting particularly stupid right now. Of all of the people in our family, he would suffer the most if we lost our mother. But at the same time he is the same ole jerk who refuses to provide her with financial assistance when she needs it the most. I wonder if there is any connection between the relationship between my parents and the problems I am having with my FOB. I don't think I will ever get married. At least not to my FOB.

The job is okay. I have my moments where I would rather fall into a hole, but then there are those rewarding moments that make it all worthwhile. Just when I thought that I couldn't speak Spanish, I got a Spanish-speaking patient. My general feeling about speaking Spanish is that I don't want my co-workers to know that I can because once they know it will become a requirement. Anyway, I coached this lady throughout her delivery in Spanish and I did okay. I can really speak Spanish after all. Last night I had another Spanish speaker and I made it through okay. Ha-ha! All those Spanish course paid off!

DiVa...Puedo hablar Espanol, muy bien!

A moment of self doubt...

2006-10-26T09:18:00.000-04:00

Business

Gosh, no one ever told me that being a nurse made you go through so many changes as a human being. I go from feeling really confident to being afraid to touch another patient to just being a raving lunatic. Mixed emotions isn't even what I would call this, it is pure insanity. I am a good nurse, I know I am, but when something goes wrong, I find myself reviewing my actions and wondering what I could have done to change the outcome from a retrospective point of view. I have been trained, I know what I am supposed to do. Comfortable, I am not. In a way I don't ever want to be comfortable, I always want to have that little feeling of "What if?"

You know like, "What if my patient codes? Then what am I gonna do?" I want my response to a crisis situation to be a reflex. A knee jerk response. I am still waiting for that to happen. Alarms are constantly going off on my unit, but I need to train my ear for the alarm that means something bad is happening. My skills are tight, I can IV and foley with the best of the best. Everything else crisis oriented, I just feel frozen. And when I do move, I am a tongue-tied, bumbling idiot. I know what to do, but I don't know what to do first. Right now I am going to treat everything like an emergency, at least until I am able to discern a TRUE emergency. I have to learn when I can be therapeutic and when I need to be stern to a patient and tell them what they need to do to prevent a terrible outcome.

I was told by a seasoned nurse that it will be at least a year before I really feel like I know what I am doing but in the meantime, I feel like a total liability. I am being told that I am doing well. I know that I have horrifically low self esteem and that I can't take a compliment, but I just don't feel right. I need to do something extraordinarily good...Soon or I am thinking about getting a job in a doctor's office where the extent of my responsibility is taking vitals and telling people to change into a gown and pee into a cup. But I bet that people code there too. I just have to find my zone. And being the Diva that I am, it won't be long before I fond it.

Personal

The kids are well. My brother came home for a brief visit from the Marines, then he was shipped to Japan. I guess that is better than the Middle East, but I will miss him and worry about him just the same. My mother had a biopsy done recently. For the past few years she has been complaining about this pain in her left arm. Most recently she told me that she has had discharge coming from her breast. This finding concerns me as my mother is post menopausal. I hope that she will be well. The thing that bothers me the most is that she was not forthcoming about her condition to my brothers. In the worst case scenario, I think I would have liked them to know what is going on with her. My Dad, he is a complete wreck. He is a jerk, but he cannot live without my mother. I am praying that everything is going to be okay.

DiVa...Someone, anyone holla if ya hear me! Throw me a life vest, I am DROWNING out here!

Musings from my inbox...

2006-10-22T06:58:00.000-04:00

Why I love my Mom...

Mom and Dad were watching TV when Mom said, "I'm tired, and it's
getting
late. I think I'll go to bed."

She went to the kitchen to make sandwiches for the next day's lunches.

Rinsed out the popcorn bowls, took meat out of the freezer for supper
the following evening, checked the cereal box levels, filled the sugar
container, put spoons and bowls on the table and started the coffee
pot
for brewing the next morning.

She then put some wet clothes in the dryer, put a load of clothes into
the washer, ironed a shirt and secured a loose button!

She picked up the game pieces left on the table, put the phone back on
the charger and put the telephone book into the drawer.

She watered the plants, emptied a wastebasket and hung up a towel to
dry.

She yawned and stretched and headed for the bedroom. She stopped by
the
desk and wrote a note to the teacher, counted out some cash for the
field trip, and pulled a text book out from hiding under the chair.

She signed a birthday card for a friend, addressed and stamped the
envelope and wrote a quick note for the grocery store. She put both
near
her purse.

Mom then washed her face with 3 in 1 cleanser, put on her Night
solution
& age fighting moisturizer, brushed and flossed her teeth and filed
her
nails.

Dad called out, "I thought you were going to bed."

"I'm on my way," she said.

She put some water into the dog's dish and put the cat outside, then
made sure the doors were locked and the patio light was on.

She looked in on each of the kids and turned out their bedside lamps
and
TV's, hung up a shirt, threw some dirty socks into the hamper, and had
a
brief conversation with the one up still doing homework.

In her own room, she set the alarm; laid out clothing for the next
day,
straightened up the shoe rack. She added three things to her 6 most
important things to do list. She said her prayers, and visualized the
accomplishment of her goals.

About that time, Dad turned off the TV and announced to no one in
particular. "I'm going to bed."

And he did...without another thought.

Anything extraordinary here? Wonder why women live longer...?

CAUSE WE ARE MADE FOR THE LONG HAUL .... and we can't die sooner, we
still have things to do!

Send this to five phenomenal women today...I just did!

Then: GO TO BED!

My first incident report

2006-10-16T12:00:00.000-04:00

Last week I had a little problem.

I work nights and on this particular night, I didn't get the rest that I am used to getting. I came into work, not feeling like I was going to have an great night. I had a choice of patients. The other more experienced yet still new "graduating in the top 5% of her nursing class" nurse said she didn't want the patient that I was getting because of her "poopy tracing" and God forbid she should get stuck with a potential crash. (Serves her right because her patient had an even "more poopier" tracing than mine!) I got report and coming in, this patient had already had one late deceleration on her tracing, which in my line of work is indicative of a non-reassuring fetal status. Also the baby had passed meconium that some consider to be indicator of non reassuring fetal status, (or possibly a mature digestive system, we are still waiting for the evidenced based explanation). Another way to say non-reassuring fetal status is fetal distress, but we NEVER say fetal distress because attorneys have a field day with that sort of thing in the event of a deposition.

So, her labor wasn't progressing. She had been 6 centimeters for almost 4 hours which can be considered arrest of labor and lead to a c-section. So it was my responsibility to increase her pitocin. The therapeutic benefit of pitocin is to generate contractions that dilate the cervix and facilitate the descent of the fetus into the birth canal creating a situation conducive to vaginal delivery. I followed the protocol, I assessed the fetal heart rate, I assessed the intensity and regularity of the contractions. The contraction pattern was irregular and non-functional, which justified my actions. The baby's heart rate indicated that he was tolerating the labor well. The patient's lungs were clear to auscultation and her blood pressure was within normal limits.

Our protocol is to increase the pitocin 1-2 milliunits every 15 minutes to a max dose of 36 milliunits per hour. At the time she was at 14 milliunits or 28 ml/hour based on the dilution of the medication in normal saline. My intention was to set the pump at 30ml/hour or 15 milliunits. The family was talking to me, the room wasn't lit very well and somehow I set the pump for 90ml/hour or 45 milliunits/hour. I walked out of the room to get ice chips for the patient. She had an epidural, so she wasn't giving me that "Oooo" that lets me know I did something wrong. It ran at the wrong rate for about 5 minutes when I noticed it and immediately changed it. I came out and told one of my nursing colleagues and she said note the chart of your error and monitor the patient. For 45 minutes nothing happened. Everything was normal.

Then the doctor went in to do a vaginal exam. All of the sudden, I looked at the tracing and noticed that the baby was having a little decel. I thought that the monitor came off so I went into the room to see what was going on. The patient was on an internal monitor. This decel was REAL! I was freaking out inside. I turned the patient from side to side and gave her oxygen. IT DIDN'T COME UP. The heart rate was 59 bpm. The doctor was still at the bedside. They gave her medication to stop the contractions and we turned off the pitocin. The heart rate finally came back up. Whew! I told the doctor of my error.

In that moment I was embarrassed because when something is going on everyone is listening and looking at YOU. Every doctor on the floor and ever available nurse was there. This is good because if you need help there is someone there. At the same time you kind of feel bad. If there was a bad outcome, it can be neither confirmed nor denied that it was a direct result of my wrong doing. I filled out an incident report. For the rest of the night I didn't want to touch her medications. Then the doctor said that I needed to give her more pitocin so that the patient could have contractions because her labor pretty much stopped. I did, but I was scared to death. I especially hate the fact that everyone knew about my mistake. I was the talk of the unit. I am sure everyone has made a mistake. Mine was minor, but I will have my eyes open from now on. Maybe someone will learn from it making my public humiliation worthwhile.

After that, one of the older 20 year veteran nurses walked me through each medication adjustment, which made me feel much better. The patient dilated to 10 centimeters and 100% effacement at the end of my shift. I imagine she delivered without too much trouble, except the fever that required antibiotics.

DiVa...Feeling not so confident but thankful for the angel over her shoulder!

Three days in a row...

2006-10-12T06:22:00.000-04:00

And I don't have to work. Working is fun, but hanging out with my kids is funner. English skills declining. Need sleep. But adjusting to this nursing thing okay. Work is still fun.

Okay some weird stuff going on at the job. About 10 nurses quit recently. Makes me wonder what I have gotten myself into now. I am one of 5 new nurses on the floor, and one of three new grads. There are three new hires who haven't started yet are also new grads. Interesting no? And we will all work the same shift. Nights. We have a really great charge nurse who we affectionately call Abuelita. Abuelita has been a nurse for almost 30 years. She is really great. She knows what is going on all over the unit at all times. She is my role model.

We have a guy nurse that works in our unit. He is probably one of my favorite nurses. Anyway he was a little hyper about an alternative lifestyle couple that came in recently. Okay he was a little more than hyper and a lot of the girls on the floor were discussing his behavior. It made me realize something. If someone has it out for you, they can make your life a living hell. They ganged up and reported his behavior to the nurse manager. I think that someone should have talked to him first or the nurse manager should have handled the situation. They didn't, they went directly to the nurse manager. Ouch! When you make a mistake on my unit the whole world knows about it. I know I will make a mistake, but I wonder what it will be like to face my peers afterwards.

The other night I was about to have dinner with my kids when I got called into work. My kids were crying. I felt really bad because I had slept all day and spent no time with them. I really have to start making myself get up in the afternoons with the kids and hanging out. Well, time to get the kids ready for school...

DiVa...Starting to get the hang of this nursing thing!

A stellar first week!

2006-10-08T18:24:00.000-04:00

This was my first full week out of orientation and I think I was alright. I still don't feel as comfortable as I would like to about reading the fetal heart rate tracings, but I know what a late decel looks like and I know what a deep prolonged variable looks like. If you struggle with fetal heart tracing here's a few links to give you an idea of what I am talking about

http://www.aafp.org/afp/990501ap/2487.html

http://www.obfocus.com/cme/fhr.htm

I will be spending some spare time studying. My days and nights are all confused like a baby. I stay up all night long, even on my days off and I sleep all day. I am still losing weight. Nursing is a very physical activity, I have built muscle and endurance from breathing with the patients and running back and forth to hike the pitocin. I find that I only really like to increase my pitocin when the patient has an epidural or when the patient has a good contraction pattern where I can see resting uterine tone in between contractions. Otherwise I need an internal monitor to assess the strength of contractions. I like to keep my patients comfortable and happy. I wonder how long I can keep this energy going.

As a new nurse I am so therapeutic. I imagine it must be sickening to my peers, but my patients like it. I wonder what I'll be like in a few years. Will I still go to work everyday with a smile on my face and a bounce in my step? Last night, one of my fellow nurses was being a little mean to one of the laboring patients. I felt sorry for the family because there really wasn't a good reason for her to be mean. She has only been out of orientation for five months and she is already disenchanted. This woman is the same lady who when asked how she felt about adjusting to her new role as a nurse said "I graduated in the top 5% of my class and I know that the knowledge is there, but everyday I feel like I am learning something new and with every challenge my confidence increases. I love my job and can't imagine working anywhere else." In addition, she passed on the legacy of the mean with the report she gave to the next shift. When I am in report and people say that someone a patient is an ass, I try to develop my own opinion.I try to find out why a person is angry. I dunno...

DiVa...Taking good care of my patients is part of the job!

Tonight's the night...

2006-10-03T20:07:00.000-04:00

Foreword
To everyone:

Thanks for stopping by, I am so happy to hear that my stories of triumph and (sometimes) defeat are inspiring. As I was going along my journey to professional nurse-dom, I often wondered if I was the only one going through some of the things I experienced. Thanks to all for your continued support and I wish you all the best of luck in your careers. You are always welcome to leave a comment or ask a question.

DiVa

And now today's news...

Tonight is my first night on my own as a labor and delivery nurse. I am scared and excited all at the same time. I am trying to do as much of my stuff for my kids' morning routine tonight before I go in to work. I live about and hour away from my job so I will be leaving shortly.

I received my student loan paperwork today and my monthly payment for my loans is $337.00 and that is not including at least two of my loans. I am out of grace in November. (Sigh...) I figured out when my loans would be completely paid off and realized that I will be 59 years old. 59 YEARS OLD! Damn. I will be eligible for retirement by the time my loans are paid off. The total amount of my loans, provided that I pay them according to the terms is $82,000. Imagine what student loans are like for doctors! If I were a professional athlete, I would make enough money in half a year to pay my loans off entirely. The priorities of our society are all jacked up!

To add insult to injury, I received my son's interim report and his grades are terrible. My old car pooped out on me and I had to buy a new one. I love my car, but my payments are going to KILL me. When it rains it pours. I am going to apply for this government program that will help me to pay off my student loans through HRSA and if I am approved I can get 60% of my loans paid. Light at the end of the tunnel. Okay, my daughter wants some attention so I gotta go.

DiVa...Wishing that she was independently wealthy!

Independent woman....

2006-09-30T13:32:00.000-04:00

Thursday was the last day of new hire orientation. Now I am on my own as a professional nurse. To me, it sounds like the most frightening group of words ever uttered by man. I will be responsible for two lives now, mother and baby. Huge responsibility. I am up for the challenge. I think...no really, I am ready.

This week I had a mom who had a BIG baby and I was doing the delivery with an inexperienced physician. She thought that she shoulders were stuck and she freaked out. I followed protocol, but damn was that intense. Luckily, I had the whole floor of nurses backing me up. Whew! Then I was delivering a young single mom with a baby's father that was a huge jerk. I told him if you are not part of the solution, then you are part of the problem. Let's be solution oriented. It did not help. Her mother was trying her best to disuade her from an epidural, which she ended up getting anyway. Then she delivered a beautiful baby boy with Down's syndrome. We have a lot of happy times, and our share of sad times too in L & D.

Right now I am supposed to be at my son's birthday party. I said I was going to skate since it is at a roller arena. Well, I'll be back later.

DiVa...blogging is my life!

Mama's gotta a brand new bag...

2006-09-21T10:06:00.000-04:00

With shoes to match!

I have only two weeks left until I get to work independently. I think I am looking forward to it. I can't complain so far, I work with a marginally decent group of people. My challenge is that I work with almost all women, even the men are woman-like. But during my training, I have not only learned how to be a nurse, but I have been socialized in the culture of nursing. I have come up with some hard and fast survival techniques for new nurses that I will share. Then I am going to take a nap because I have to work until 3 o'clock in the morning.

1. Avoid floor gossip at all costs.
This is probably the hardest of all because when there is a break in the day, every one gets together to talk about how "Nurse A" has migraine headaches and she calls off every week because she has a headache and how it is not fair that she can use FMLA to excuse her absences and how she coincidentally has a migraine on X-mas day, New Year's Eve, Thanksgiving and any other inconvenient time. If you find yourself talking about someone when they are not present, make sure you are saying nice things or things that you don't mind being repeated because trust me, it will be repeated and you might get confronted.

2. Get a tough skin and try not to go off in front of a patient even when "Dr So and So" is being a dick!
This has happened to me, and I act like I don't even care. Don't ever cry in front of an "authority figure" because then they know your weakness and you will get hosed every time. Sometimes, I will even laugh and say some crap like "Take it easy dude, even though I am a DiVa, I am still new." Save your crying for when you get home or in the bathroom or whatever. Personally, I went to school with a whole bunch of (pardon my saying so) Bitches (students and profs included) so I am almost numb to this sort of crap. And besides, they can't kick my ass anyway!

3. Even if you don't know what the hell you are doing, walk around with poise and confidence.
I call this my poker face. Inside I am a nervous wreck, on the outside I look like I have been doing this nursing thing my whole life. If I am confused about something, I ask a question in a way that sounds like I am confirming what I already know. I think it must be working okay because people have an awful lot of confidence in my ability to care for patients. Maybe I am better than I think I am, but I never make any assumptions.

4. Smile and say hello to everyone from the nurse manager to the environmental services personnel. Be genuine and nice. Help out whenever and where ever you can.
You will be surprised where the best help can come from when you don't know which end is up. I am always willing to help someone at all times and I have found that if I overhead page for help, not a code but just for assistance I have a team of people in my room and each one takes a job without even being asked. Seriously, it's amazing. If I feel uncomfortable with the way that anyone treats me I'll ask the person directly if they are having a bad day, or if I did something wrong. Mainly I address the behavior by saying something like "When you speak to me that way, it feels like you are yelling at me" or "Can you show me the proper way to do whatever" and I find that people give me good feedback. If there was a misunderstanding, it is okay. We talk it out like adults. They didn't beat me up or cuss me out or anything.

5. Be prepared to get crappy work schedules as a new employee. Don't complain or whine. Just smile and say something like "Those are the breaks" and move on.
It is just a fact of life. Nurses with seniority get whatever they want and new nurses have to earn their way. But there is always a nurse on the floor who knows how to work the schedule. Find that person and ask them to teach you how to make out your schedule. You'd be surprised how far creative scheduling can get you.

*Bonus! Try to have fun and remember that your job is all about taking care of the patients. If you make a few friends along the way and it is all fine and good, but if not remember you're a nurse!
You can transfer anywhere you want. We are one of the few professions with the versatility to work in any clinical area. I am giving this job two years to happen for me. After that I will re-evaluate my career and make a decision about where I want to go next. I have the ultimate power over whether or not I am going to have a good experience or a bad one. I leave my home life at home and my work life at work. And besides, my personal life is none of their business anyway. And believe me, they will want to know your business. Have a little mystery about yourself. It is fun. None of those people HAVE to be your friends, they are co-workers. The less people judging you the better.

Alright, enough wisdom for today, I will be back soon.

G'night!

DiVa...A nurse with the moxy to keep it real!

Playin' catch-up

2006-09-14T15:21:00.000-04:00

I am excited about my new career. As a matter of fact, I got my first raise. Seeing my paychecks give me a sense of hope for the future of my family. Yeah, I know I sound crazy, but I have made some observances about making enough money to take care of my family.

1. I don't have to borrow money to take care of my kids. I spent almost $600 on my kids for school uniforms and supplies and my bank account was not overdrawn. And I still had money left over to pay my bills and put gas in my car. Wow!

2. My ex-fiance and I have been getting along a lot better lately. (Big Surprise, no?)Recently, he has been helping me out with the kids. And he realized that he needed a car to do this with. I was the designated co-signer, but I declined because I don't think he deserves it. Why the hell should I co-sign for him. I guess the most amazing thing is that the banks will actually let me, ME have a new car.

3. I buy lots and lots of pretty clothes and shoes for myself. I have better clothes than I had even when I was in high school! And I have money left over to go out to dinner and pay for my meal without taking $20 off of each bill to afford to go and have fun with my friends. I just went out this weekend and spent $60 dollars and my lights and gas are still on! My rent is paid!

I know I am silly, but I can afford to enjoy life. I have to get my credit in order and start saving now because I plan to get a new house. At least a bigger house where all of us have our own bedrooms. I am thinking of moving a bit closer to my job. The schools closer to my job are having problems with finance and quality of education. The town where I live right now are building brand new schools that will be done in 2008. I think I should stay here, but I have to drive at least one hour to get to work. I have a huge decision to make.

I know it is too soon to say this, but I think I love my new job. I especially LOVE working in the OR and triage. I know you must be thinking, are you really a OB nurse? Yes, our OB is a high risk OB. That means we are prepared for anything. We take all pregnant with things as simple as a toothache or as complex as a placental abruption. They only rule is that they have to be at least greater than 18 weeks pregnant. I think I'll be okay working unsupervised. And the people on nights are fun!

Since I am a new grad, I am going to get hosed on the holidays. I will probably be working Thanksgiving, X-mas eve definitely, x-mas day and New Year's. But since I work nights, it shouldn't be so bad. I hope.

With less than a month of orientation left...

2006-09-12T00:51:00.000-04:00

I am doing remarkably well.

I can birth babies with minimal assistance. I can circulate and scrub in obstetrical and gyn procedures, I can triage. I am almost working independently. The funny thing is, I am already teaching student nurses. Today was a day that I could have choked a few student nurses. I always wondered what it was like on the other side of the fence. Now I know.

Most of the student nurses that I have run into were cute. The reminded me of myself. Inquisitive, helpful and focused. They ask really good questions. I am impressed. But there are a few student nurses that make worry for the future of nursing. Case in point. Today there was a group of student nurses in the OR observing C-sections and things of the sort. It was my second time scrubbing in by myself and I was nervous! I memorized all the instruments, and I am working on anticipating the doctors need, so I was rehearsing the procedure in my mind while I was setting up my sterile field. I don't know about you, but when I was in nursing school, I was taught two things about being in the OR, 1. Don't touch anything! Especially anything or anyone dressed in blue, and 2. Keep your hands in your pockets and stand up against the wall that way if you faint you won't hurt yourself.

I don't know what this guy was looking at but he was standing behind me. The patient wasn't draped, there were no doctors in the room. I think the nurse was placing a Foley or something. The all of the sudden I felt a bump. In my mind I said "Shit!" Out loud I said "He bumped me! Ack! What do I do?" I know full well what I had to do, I had to re-scrub all over again. I told him it was okay. It really was, because ya know, it could happen to anyone. I guess it was partially my fault because I should be aware of my surroundings, but whatever. I re-scrubbed and went back to setting up my sterile field, but then I was REALLY nervous.

My mask and shield fogged up and I was sweating like crazy. In my mind I am playing the worst case scenarios, me knocking over the entire Mayo stand with surgical instruments all over the floor. One of the doctors yelling at me like "Get this incompetent nurse outta here and get someone who knows what the HELL they're doing!" I couldn't see a thing. Fortunately, I could see the tips of the surgical instruments and I memorized where I had everything set up. All of my counts were correct in all three cases. Once I thought I had lost a Kelley clamp, but then I realized it was on my placenta. Oh, and I dropped a pair of pick-ups off the field. Simple job, HUGE responsibility! The doctors seemed to be impressed. The DiVa still can't take a compliment.

After the case, I was scrubbing my instruments and I happened to track blood on the floor. At the moment, I had an unlabeled placenta that needed to be stored properly before it got mixed in with all the other placentas and I was going to call environmental services to help me with my bloody footprints. One of the nurse assistants (i.e., student nurse that works on the floor until they graduate and take boards) called me on the carpet about the bloody footprints. Now, They were not like a forensic crime scene, just light pinkish-red smears of blood. I didn't even leave the footprints unattended. She is always screwing with me. Student nurses have some BALLS nowadays! When I was a student nurse, I respected nurses (experienced or not)and I wouldn't DARE try to say something that would piss them off. I have already said something to her about her saying, "I WOULD help you BUT YOU'RE the NURSE-IN-TRAINING and you need the experience." or "I would have started that IV differently than that, I would have went for the anticubital but do it your way." Or my personal favorite, "Hmmm, looks like you have five minutes to get dressed and get into report! Better hurry up!"

Other than that, all is well. I think I will be okay. But I just know, my first week out of orientation will be all the worst OB cases every known to man.

DiVa...The girl who went to the club this weekend and found out just how fierce she really is!

Why I oughta...

2006-08-11T05:14:00.000-04:00

Today has been the most frustrating orientation day to date. I am pissed off at the residents right now. While I understand that they are students, I also need them to understand that I don't know everything there is to know about being a nurse. I have a few choice profanities on my lips at this moment, but my level of professionalism won't allow me to type them. I digress...

Today I attempted to do my first delivery by myself. This is the second time. The first time I said screw it and let me preceptor take over. At most facilities there are two nurses that handle deliveries, the baby nurse and the mom nurse. At this facility I AM the baby nurse and the mom nurse. I have two preceptors. One lets me do whatever I feel comfortable doing and the other doesn't seem to trust me enough yet. Since I attended a very pretensious university in my area, I am reluctant to step up and say "Get back, I think I can handle it." I don't want people to say, that DiVa is a snobby bitch but in a minute, I am gonna let my nuts hang. Screw em!

In L&D, we have these tracings that represent the fetal heart rate. My preceptor was in another delivery and she was attempting to let me handle it, which I must say, I was kickin' ass. So I noticed that the fetal tracing was sucking really bad and decided to tell a resident. The first resident said, just turn her over and give her oxygen. I did that and the tracing was still not so good. So I asked a second resident what I should do and she pretty much reamed me out. And then was a little pissed off because I wasn't running through the halls like it was a full code situation. The DiVa just doesn't freak out like that, mainly because I didn't want my teenage patient having her first baby to freak out. Long story short, she was ready to push.

So then all the residents were in the room, and my preceptor told me to coach my patient while pushing. Here I go..."Take both arms and reach around your thighs, curl your body around your baby, take a deep breath and push down into your bottom like you are having a bowel movement." I practiced saying that 1,000 times so that I could sound like I knew what I was talking about. Before I could try it out, the resident takes over. This made me feel like she thought that I didn't know what I was doing, and I thought it kind of gave my patient the impression that I didn't know what the hell I was doing. I was cool.

Then the attending physician came in and reprimanded me about the way that I was holding the patient's legs. My patient wasn't complaining. The baby crowned and It was time for my "wonder twin" nursing powers to activate. While I was tooling around the birthing suite, running back and forth between mother and baby, the attending decided to ask me if I had addressed the mother's positive chlamydia test that was done on the 28th of July. Of course it was done by a resident, but not documented. Again making me look like an idiot in front of the patient. My preceptor was silent. So I assumed that I was doing okay. Then I guess I was moving too slow. I don't know, I guess I am still trying to find order in chaos.

I had extremely low confidence today. After that whole encounter, I wanted to walk out. But then , my preceptor told me I was okay and that I shouldn't feel too discouraged because I am cut out for this job. I felt a little better. I was supposed to leave at 11pm but I stayed until 3am because I am not going to let this job beat me. I am tired, so I think I am going to call it a night. Besides tomorrow is another day.

-DiVa...Birthin' babies with attitude and latitude

Long time no blog

2006-08-04T20:44:00.000-04:00

I have been busy. It is time for the kids to return to school. Time for me to return to school. Time to get this job thing happening. I have seen some craziness these past few weeks. Babies born in the bed, women with infections so bad that a bath doesn't alleviate the vaginal odor. Kids born with congenital anomalies. Last week I had my first run in with a fetal demise. Yeah, what you want to hear I'm sure.

From what I was told, the young lady (age 16) called the hospital on a Sunday, complaining that she hadn't felt her baby move since Friday night and fluid was leaking from her woman parts. She was 37 weeks gestation, never had a baby before but she new that something wasn't right. So she came in and she was given an ultrasound. There was no amniotic fluid, which generally means the baby is no longer living. So her labor was induced. When a person is as far along as this young lady, she has to labor and push the baby out, even if it is dead.

The baby came out looking like a typical newborn, except not alive. I was sent back to look at her because they thought it would be better for me to see one before I actually had to take care of one. By the time I saw the baby, she had started to change colors and the head had become gelatinous. She was dressed in a onesie and had on a little cap. I asked how they thought that the baby had died and the said that it probably got tangled in its own cord. It was delivered with the cord wrapped tightly around the neck twice. I felt sick after observing this baby. I had a bad day after that.

On this particular day, I had an alternate preceptor, she was such a bitch. Thank God I only had to be with her for only one day. She was so mean to the patient's family it was embarrassing. When she found out that it was the family of the fetal demise, she felt bad, but she didn't apologize. My preceptor spent the whole day yelling at me for a variety of things. It took everything to remain professional. She observed me as a performed an IV stick. I have to do a pre-determined number of IV's and blood draws while I am in orientation.

She directed me to find a bifurcating vein and insert the catheter between the area where the two veins intersect while threading the catheter into the lumen of the vein that is straight. She also wanted me to anchor the vein above the sight which I am totally uncomfortable with because doing this increases the risk of needle stick injuries. I had never done an IV this way before and I was not wanting to experiment on the patient. The patient didn't want me experimenting on her either. The whole time she was saying, "You're gonna miss. "I know it." "I hate needles." As I am sure you could probably guess, I missed it. I felt defeated. At least she apologized for that.

Right now I am trying to treat me house for fleas. My darling kitten has them and now my ankles are getting bit the hell up. I set off a flea bomb while I was at work and my ankles are still itching like crazy. Aw hell. Gotta get ready for work tomorrow.

DiVa...Why won't these damn fleas DIE?

Down to the nitty gritty...

2006-07-22T23:07:00.000-04:00

I am finally in my clinical area. Today I received my first paycheck and I must say, nursing school has certainly paid off. I am in orientation, and will remain in orientation for the next 11 weeks. The upside...I have two awesome preceptors that love their job and are excellent teachers. The staff is an interesting cast of characters that support each other the way that nurses support each other in hospital utopia. Keep in mind, all this is coming from an observation period of approximately 4 days. Case in point.

On my third day as a bonifide nurse, I had a patient that had been pregnant 14 times with 4 living children and 10 miscarriages, one of which was induced. (For those who follow the OB short hand that's gravida 14, para 4, T=4, P=1, A=10, L=4) She was an interesting case with a history of cocaine abuse and a laundry list of sexually transmitted diseases. The funny thing is that she REFUSED to sit on the toilet. My nurse said the toilet seat should have been afraid of her ass instead of the other way around. Anyway, after her delivery, we were preparing to send her to post partum. She was in her wheel chair and everything when she decided she had to go to the bathroom. Her estimated blood loss was 150cc. Which is unusual for a multipara. I assessed her before multiple times we put her in the wheelchair and each time her uterus was firm, except for one assessment where I kinda thought she was a little boggy but even then my preceptor went behind and re-assessed the uterus which was firm and at the umbilicus.

So the patient was in the bathroom, squatted over the toilet looking at her butt as she was peeing, leaking blood etc. She said, "I want to get out from over the toilet, but I am still bleeding." At the moment, my preceptor was at the nurse's station giving report. I re-assured the patient that some blood loss was normal. I asked her to stop looking at her crotch and put on her mesh panties/pad and return to the wheelchair because the way she was bent over looking at her crotch could cause her to become lightheaded and faint. She finally sat down and then she started complaining about the bleeding again. She complained and I checked her, she complained more and then I went to check her for the 10th time and she was gushing a little blood around her pad. I thought perhaps it was because the blood was pooling from the way she was sitting so I walked to the nurse's station and asked a few of the nurses to come and take a look. They asked her to return to the bed and palpated the patient's fundus/uterus.

*This is the point where you would want to stop reading if you have a weak stomach!

As the nurse rubbed her abdomen, about four to five very large clots shot out of the patient followed by a very large volume of gushing blood. It was like a horror film. The nurse said, "Go get one of the attendings." At that moment, my preceptor turned the corner and she took over. I was so glad, because I had no idea what to do next. I was so glad that the other nurses were able to jump in and help with my patient in the absence of my preceptor. What happened when the attending physician arrived was something I have never seen before in my life. The doctor put on a rubber glove and inserted her entire hand almost up to the elbow inside the patient and proceeded to perform what I imagine to be a manual D & C.

They were pulling stuff out of the patient and pulling it apart in an attempt to assess what is was. The placenta was expelled hours before, but they thought that perhaps there was more tissue inside of the patient. The patient was sitting in a pool of blood and other miscellaneous stuff. The patient thought that she was dying, her blood pressure was 67/25. So then we gave her a huge bolus of lactated ringers. Then they gave her a bunch of pills rectally. I left before they decided what to do next.

*The gross stuff is over now!

There are a lot of sad stories on my unit. Women laboring alone. A 250lb 14 year old in active labor with chronic hypertension, type 2 diabetes and a 23 year old boyfriend who gave her trichomoniasis and genital herpes. A 16 year old having a baby with a 17 year old boyfriend who has a 2 month old daughter with another girl. These kids are too young to be having these sort of problems, but this is only week one. I am sure that the stories get even more astounding. Everything is going well. I guess it is to early to say for sure, but I think I am really going to like my job.

DiVa...surprised that she is adjusting to work so well!

This was too funny not to share...

2006-07-12T20:52:00.000-04:00

Foreword: I can't take credit for this, my aunt sent it to me today!

From a strictly mathematical viewpoint it goes like this:

What Makes 100%? What does it mean to give MORE than 100%? Ever wonder about those people who say they are giving more than 100%? We have all been to those meetings where someone wants you to give over 100%. How about achieving 103%? What makes up 100% in life?

Here's a little mathematical formula that might help you answer these questions:

If:
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

is represented as:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26.

Then:

H-A-R-D-W-O-R- K
8+1+18+4+23+15+18+11 = 98%

and

K-N-O-W-L-E-D-G-E
11+14+15+23+12+5+4+7+5 = 96%

But,

A-T-T-I-T-U-D-E
1+20+20+9+20+21+4+5 = 100%

And,

B-U-L-L-S-H-I-T
2+21+12+12+19+8+9+20 = 103%

AND, look how far ass kissing will take you.

A-S-S-K-I-S-S-I-N-G
1+19+19+11+9+19+19+9+14+7 = 118%

So, one can conclude with mathematical certainty that, while Hard work and Knowledge will get you close, and Attitude will get you there, it's the Bullshit and Ass kissing that will put you over the top
Don't you just Love it!!!

Three down, two to go!

2006-07-12T20:09:00.000-04:00

I have been pretty busy here the past few days, so I'm gonna get ya up to speed. I have found out some very interesting and exciting things about all the new training that I am about to receive, but nothing gets to happen until I finish this dreadful orientation. My initial thoughts were, "Ahhh, orientation class shouldn't be too bad. I am getting paid to listen to lectures and such, how could I miss?" Oh yes, I can miss, I miss being busy on the floor.

Yesterday
We sat through about 6 hours of lecture. Because we were a mixed group of aides, techs, supports, LPN's and nurses our training was remedial. When I say remedial, I mean like "Intro to Nursing" simple. We talked about HIPAA and patient safety and stuff like that for hours and hours and hours. The delegation lecture was pretty informative. Everything else is a huge blur. After about the first three hours of lecture, our manager came down from our respective units and met us for the first time since the interview. I thanked my manager for hiring me and she told me what to expect and what I need to do to prepare for my first day on the unit, which is next week.

She told me about my training. I have to renew my adult CPR, take a neonatal CPR course and a Code Pink course where (get this!) I learn how to run a code on a preemie and they will be teaching me how to intubate a neonate by practicing on a real live CAT in the lab. That's right. A feline. My Auntie told me I better hope it's declawed. I am hoping that the cat will be sedated! Then I have to take classes on perinatal loss and become a lactation consultant. I am going to be so well trained that the NICU that turned me down before will be dying for me to work for them. In this moment, I can't imagine working anywhere else. Our unit is required to wear navy blue. After school/work I went to the uniform store and bought myself pretty new scrubs for my first real day. I can't wait to wear them.

Today
Mundane is putting it lightly. I feel so bad because there were people in our class that probably never did a blood draw before that had to pass a proficiency after only watching a demonstration ONE TIME. They didn't even get a chance to practice. This part of the orientation has been like the abridged version of nursing school. All day the teacher talked, and talked, and talked. I am so happy I am home because here, there is peace and quiet.

I took my med math test and passed it 100%, which means I can pass medications. I passed all of my other competencies 100% as well. I wasn't so lucky with my test on restraints. I'll be honest, I didn't really read the material. There, I said it. It was a very dry read, and you know I am suffering from that "Nursing School Induced Anhedonia" which I really gotta do something about. I brought the book home and perhaps I will read it while I do laundry and then take the test first thing in the morning. Then I have a few more independent studies and a class on the hospital computer and then I am free to go onto my unit. Thank God!

Well, that's about all.

-DiVa...Tired as hell from doing nothing at all!

Orientation

2006-07-11T03:46:00.000-04:00

It is the middle of the night after my first day of orientation. Why am I awake at 3 o'clock in the morning? I am washing an outfit for today. My first day of orientation was great. I was on time, which is a huge feat for me. I arrived early enough to get my fingerprints and ID before going to the classroom. They offered a breakfast of pastries, muffins and bagels. There was also coffee and juices, which was very nice. There was a mountain of paperwork regarding benefits and at least 8 speakers.

I learned that ANYTHING can be misconstrued as sexual harassment. I am not going to tell anyone that they look nice, I am not going to look at anyone for longer than 2 seconds or read any magazines because God knows that Louise or David might see a picture of a swimsuit model or bodybuilder and feel uncomfortable enough to report me. I was wondering why this guy one time when I was working nights looked at me so strange when I said his aftershave smelled nice. They were saying that even a glance that makes someone feel uncomfortable is sexual harassment. Two employees sharing a dirty joke amongst themselves in the break room is sexual harassment. Kicking the vending machine and saying F---! is sexual harassment. I was sexually harassing him! Sexual harassment is EVERYWHERE. Watch out...

Besides that everything was okay. The rest of the week, the hospital has devised this mini-skills lab that will teach us everything we ever wanted to know about nursing but was afraid to ask. Our first lessons include delegation (that we never really covered in nursing school and I needed for the NCLEX), customer service, and skills (which are my favorite). Just when you thought that nursing school was over, they bring it all back with your first job. We are re-learning phlebotomy, body logistics for turns...Everything! They are teaching us how to order things in the computer and a have to take a med calculation test. (Yay?) I get to meet my boss today (for the first time since she hired me), and my preceptor. (I am trying to stay optimistic!) I don't get to dive into the REAL nursing stuff until either later this week or on Monday. But I will be back to tell you more about that. Alright, I am going to put my clothes in the dryer, pack my lunch and go back to sleep.

Until next time...DiVa!

Pre-employment and such

2006-07-07T23:44:00.000-04:00

Today, I had to go to the hospital to complete some pre-employment screening type stuff. Even though my drug test is going to be negative, I still worry a bit. I was at a party near a window where some guys were smoking weed outside. I was freaking out. I hope that second hand smoke doesn't generate a false positive. I wasn't like concentrating and inhaling or anything, I just happened to notice an odor of burning marijuana leaves. I should be fine because that was over a week ago.

Then I had to get a TB test. No big deal. I have to get another one done next Friday because the hospital needs to have a history of one negative test within the past year. No prob. After that I had to go to the lab to have blood work done. As I was instructed by the Blood donation people, I extended my right arm. The tech couldn't find my only two good veins. She decided to go for one of the faint blue lines on my left arm. She had to go deep to hit it and she used a butterfly needle. She made it on the first stick, which is good, but now I have a bruise the size of Texas on my arm.

Then I had to go get an ID made. It was a great picture, amazingly. Then I needed to get fingerprinted. I gave my driver's license, but the officer needed an ID with my social security number on it. Since I don't carry my social security card, I was out of luck. After that I decided to go home. Today, I had my daughter with me and she was so spoiled. Everyone couldn't stop telling her how cute she was and the gave her a light lunch, candy and coloring books. She said, "I like your job!" I wonder why.

So I start my job on Monday. I am not ready. I can't believe I am using this combination of words together in a sentence, but I would almost rather write a paper. I hope that I don't disappoint the unit, or screw up something. I mean, I don't worry that I will kill anyone, but I am more concerned that I will not be what the nurse manager expected. That is really silly, but that's my big fear. I wanted to ask the nurse manager why she hired me just so I could try to meet her expectation, but I thought that was kind of weird. So I will just do my best to be a good little DiVa.

I know I am probably not going to like everyone that I work with, but I hope that I work with marginally nice people. I am also hoping that work will be nothing like nursing school at all. My biggest weakness is time management, so I hope that I will be able to make it to work on time everyday. I live almost an hour away from the hospital and I have to get dressed in the facility because they don't allow you to wear your scrubs or shoes in from home. I imagine that all of my questions will be answered soon enough. Well I have a huge stack of papers that have to be filled out before my first day.

DiVa...I don't wanna let em' down!

P.S. I got a new microwave for $40 at Best Buy.