Friday, April 28, 2006

A Series of Ridiculous Situations

You want anecdotes? I HAVE anecdotes.

Act I: The Project
I recently completed a final project in pharmacology. We were assigned in groups and given a MAR (med administration record) listing 10 drug orders. From this list alone we had to figure out the patient's many medical diagnoses, develop a plan of care, and uncover the various mistakes, interactions, and risks associated with the given orders.

It was nightmarish to say the least, but we got it done. Everyone ended up arguing over why the person wasn't on Lasix, and whether we should point out the combination of a "-pril" and a "-tan" as a mistake even though we have seen this combo in the hospital before... well anyway I don't want to get into a bunch of jargon. The list of stuff goes on and on. The point was that it was a freaking hard assignment. The good thing is I really feel like my studies this semester prepared me well.

But there was something Pharmacology didn't prepare me for...

Act II: The Standardized Test
Each semester we are expected to pass a series of ATI Exams before moving on the next level. ATI scores don't affect our grade. They just provide benchmarks to gauge our competency and predict our NCLEX scores. I finished up the Fundamentals exam last week and took the Pharmacology one today. You only have to make a 65% to pass (which may seem low until you consider the fact that the national average is only 63%).

I took a few practice tests to warm up. Scored in the high 70s, so I figured I was safe. Even when I missed a question on the practice test, my second choice was usually right. I waited outside the computer lab with confidence...

...until student after student came out looking dismayed. "Failed it by one question" they'd say. Ack! Apparently the class was right on par with the national average. When I finally logged in and began my own test, I had that sinking feeling of impending doom. I had never even heard the names of several of the medications before. I guessed many, MANY times at the answers. The proctor caught my expression and came over to pat me on the back. "Take your time, Heather! Everything will be okay."

I looked up at her sadly as I hit the score button. "I know I did horribly. I was only certain of about 10 of those answers". She glanced down at the screen and made a noise of delight, and my eyes followed hers. I'd made an 80%. Apparently it was one of the highest scores in the class.

After the initial shock my first reaction was anger. "This is stupid!" I said. "There is no way this is an accurate score of my ability! There is no way this will indicate my success rate on the NCLEX! I guessed on almost everything!"
"Maybe you're a really good guesser then. It's impossible to know the effects of all the drugs. You've learned HOW to think about them this semester, so you can apply it to the others."
"No. That's not good enough." I said. And it's true; we're dealing with people's lives here. I need to know what side effects go with these medications. I know I can't expect to learn it all immediately, but damn it, I don't want to make a "good guess" about toxicity symptoms. I want to have time to learn it now. But there isn't time.

She was unphased. "You know best what you need to study. Do that, and don't worry about it."

So I guess I won't worry about it. Still makes me angry though. That test is flawed. A big mistake.

But not as big a mistake as my last story...

Act III: The Shirt
My friend Meredith and her girlfriend Cris have started making tie-dye. Anytime Meredith gets excited over something cool she HAS to share it with people, so on the last day of clinicals Meredith brought her latest tie-dye shirt for our inspection. She described the process of creating the tiny folds just so in order to make the intricate zig-zag pattern across the front. She spent days on it. It was a cool shirt, as tie-dye shirts go. We were all proud.

We took Instructor Sarcastic (also known as Instructor Incredible) out for lunch on the last day of clinicals. We gave her some gifts and a card to let her know we appreciated her teaching. I made her this little picture and all of us signed it:
(Everyone thought it was cute. I might use something like it for SNA shirts next year. What do you think?)

But anyway, back to the story:
Meredith wanted to show off her tie-dyed shirt, so she held it up for our instructor to see. Instructor Incredible smiled with delight. "Oh! Thank you!" she said.

What a sad misunderstanding! I could see Meredith's face fall as she realized that she wasn't getting her shirt back. Everyone at the table got big eyes and looked over at her. No one knew what to say. Of course, it wasn't exactly the best timing on her part. And she has a way of handing things to people that somehow conveys a finality... but still! Her pride and joy, mistakenly gifted away. I don't think she even got to wear it once. Instructor Incredible, on the other hand was thrilled. She pulled it over her head immediately and praised it and profusely.

Meredith has a really sweet heart, she just smiled and said "You're welcome"... and let it go. There will be others, after all. Later, when I asked her how her day was, she looked at me flatly. "I lost a shirt."
"Look on the bright side," the others intoned. "Maybe this will help your clinical grade a little?"

Meredith laughed.

The lesson of all this kids? Study hard, study hard, and keep smiling.

Good luck on your finals everyone!

13 Comments:

Hi Heather,

my name is Joe, i live in germany and sometimes read your blog.
I write this email to you, because i am the founder of the german "PflegeWiki", a wiki-site (just like Wikipedia) in german language, specialized on nursing information.

As our german wiki has currently 2.919 articles, we started an english version yesterday.

You can visit it by following the link http://en.nursingwiki.org

Well, it would be very kind, if you could give a credit to NursingWiki at your blog-site

Sorry for my ugly english,

best regards,

By Anonymous Joe Schlarmann, at Monday, May 1, 2006 at 4:21:00 AM PDT  

Oh man, that sucks that your friend lost her shirt! It stinks when something like that happens...it's happened one too many times for me! You are right, she handled it like a pro!
I have a question if you have time, I am starting pharmacology this summer. Do you have any hints to help me to be successful in this class? I have butterflies and your post described my fears!!! Thanks!

By Blogger Eve C., at Monday, May 1, 2006 at 9:32:00 PM PDT  

No guys in your clinical group?

Whatever the case, your uniforma are pretty cool. You should see the ones we have to wear at our school. Bsby blue and white like Smurfs.

Also, we don't have to take ATI testing until senior year, and even then it is only once.

By Anonymous S. R., at Monday, May 8, 2006 at 7:32:00 PM PDT  

hi girl,,i'm very glad to know all about you. i'm a nursing student too. my college is at the Adventist University of Indonesia. now,i will begin this 4th semester. i see that i've a many challenges this semester,so i must study hard,especially i must study and always practice an english lesson more..yeah,i hope and sure that i can finish my education in Faculty of Nursing,and i want to continue my education and to take a specialis surgical of child..please give me your advices for my future,,thank you soMuch..

By Anonymous Anonymous, at Tuesday, January 15, 2008 at 6:17:00 PM PST  

HI HEATHER,

I AM A CURRENT STUDENT NURSE IN MY FIRST YEAR AND HAVE TO TAKE THE PHARMACOLOGY TEST FOR ATI THIS WEEK. UNFORTUNATELY AT OUR SCHOOL WE RECIEVE THE BOOKS AND NO EDUCATION TO GO WITH IT REGARDING ATI TESTING. WE HAVE NOT HAD A PHARMACOLOGY CLASS NOR DO WE RECIEVE ONE IN OUR 2 YEAR COLLEGE PROGRAM. WE ARE ALL SOOOO SCARED. WE HAVE ALREADY TAKEN OUR FUNDAMENTALS, MATERNITY/NEWBORN, AND NUTRITION. I HAVE FORTUNATELY PASSED THEM ALL EVEN SOMETIMES WITH THE LOWEST POSSIBLE PASS %, BUT I AM JUST GLAD TO PASS THEM. OUR TESTS COUNT AS PART OF OUR THEORY GRADE UNLIKE YOURS. THE PERSON WHO RECIEVES THE HIGHEST SCORE GETS THE FULL 25 POINTS, AND IT TRICKLES DOWN FROM THERE! IT SUCKS WHAT I CAN SAY! GOOD LUCK IN YOUR CAREER! NURSES ROCK!

By Anonymous Anonymous, at Monday, May 26, 2008 at 10:25:00 PM PDT  

Hi I find your blog articles very interesting. Even the look and feel of your blog is very good.

By Anonymous Medical Taining., at Monday, April 27, 2009 at 3:06:00 AM PDT  

Heather, I am taking the Pharm and Fundamental test this week at Northwestern. Just did the pretest, and about half the drugs on it we NEVER covered. Im pretty pissed off about that. I was looking up the drugs that we didn't cover and ATI didn't agree with Davis for the answers on a few. Maybe I can make an 80, but I dunno

By Anonymous Matt, at Sunday, November 29, 2009 at 4:03:00 PM PST  

Hi,
My name is Samantha, Im in Year 11 (10th grade i think?) and am trying to figure out which subjects to choose next year.

I've always been talented at English, History and Art but i really feel that i would prefer child nursing. However, my mum says that nursing is not for very talented people (which she thinks i am...)

Would you say that nursing is a good job for gifted people?

Thanks so much

By Blogger s_sintnicolaas, at Tuesday, September 14, 2010 at 9:16:00 AM PDT  

Samantha, I assume you're not from the US. I'm not certain about the differences between nursing practice in other countries, nor the way your education system is set up. In general, it is best to aspire to higher education because it affords you more opportunities.

However, I was considered gifted when I was a child. I was enrolled in special classes and made high grades. Unfortunately, you will find that once school is over, labels like that are meaningless. It's about what you actually do, not what you have the potential to do.

People tried to tell me nursing was beneath me, and that I should be a doctor. But I didn't want that life, and want it even less now that I've seen what it entails day to day. A smart, competent woman is in no way wasted in nursing. As in any job, there are many foolish and unintelligent nurses out there. It's the people who excel who build our profession.

If you truly aspire to be gifted, do want you want to do, and do it well, with your whole heart.

By Blogger esunasoul, at Wednesday, September 15, 2010 at 7:18:00 AM PDT  

hi heather hw r u ,,my name is harmeet singh jassar from surrey bc canada i have done Bsc nursing 4 yrs from India dis year right,,i have 6.5 in speaking ,will they consider 6.5 or i have to do it again IELTS ,can you tell me what should i do please i am very tensed about it ,,i have to approve my credntials..
my email is mr.harmeetjassar@gmail.com

By Blogger harmeet22, at Tuesday, December 28, 2010 at 9:10:00 PM PST  

Dear Heather,
My name is Kimberly and I am currently a Jr. in a PA High School, I want to let you know, you have inspired me :) I want to be an RN "when I grow up" and my high school has amazing programs to help me do so. To see you being honest in your blog, and seeing that there are nurses out there that are not just there to get the money, but that you truly care about the people you see. Good luck in your job, I think I am a little late for that :) I hope to meet you someday.

By Blogger Unknown, at Tuesday, February 7, 2012 at 7:46:00 PM PST  

Dear Heather,
My name is Kimberly and I am currently a Jr. in a PA High School, I want to let you know, you have inspired me :) I want to be an RN "when I grow up" and my high school has amazing programs to help me do so. To see you being honest in your blog, and seeing that there are nurses out there that are not just there to get the money, but that you truly care about the people you see. Good luck in your job, I think I am a little late for that :) I hope to meet you someday.

By Blogger Unknown, at Tuesday, February 7, 2012 at 7:48:00 PM PST  

Thanks Kim, means a lot. Nursing is what you make of it, and is always bigger than any one job or city. May you be a good one. Dream big. :)

By Blogger esunasoul, at Wednesday, February 8, 2012 at 10:32:00 AM PST  

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