A classmate saw me reading before class this week and asked, "How can you find time to read?"
When I was a graduate student, I came to the realization that the more that I learned, the more I could see was out there to learn.
Still suffering from the group-think exercise known as indoctrination to the medical model of cultural competence, I was interested to see a former colleague from my doctoral days featured in this article*. It's about UCSF's DIVA program. Who knew this program even existed? Certainly not I, and I've been with this institution since I was barely out of my teens. Well, not only does it exist, but it's headed by the socio-cultural issues in health care instructor, as well as the much respected Howard Pinderhughes. I have some reservations about the article, even though I understand what its trying to do. My sense is that the way to the heart of this problem is not through the individual and his/her experience, as the informal "research" that the program is based upon suggests. It is, in fact, where the whole issue tends to fall apart. But, we can't do much about that, so, for the time being, MEPNs should pay attention to the article and hopefully, one of you will get involved with the DIVAs. They need some students to contribute his/her real-world experience (outside of nursing and outside of anthropology/sociology) and to give allied feedback about our clinical and classroom experience. It's worth it. Even if you have to belong to a group with the world's stupidest name.
I was unexpectedly wrangled by the last few days of classes. The socio-cultural class knocked the wind out of my sail and I'm in some sort of recovery period (a.k.a. funk). Anyway, I forgot to mention this nice, brief interview with Donna Haraway that appeared in The New Scientist. Although she's talking about her favorite new-ish subject, the companion species, I think it relates nicely to the fore mentioned conundrum that continues to wrench my gut.
So, one of the great things about MEPN is the community rotation. Today I learned that as a part of my placement I will not only be doing immunizations for the flu season, but also in-home prenatal Hep B screening, communicable disease education and screening, and we will all participate in a countywide bio-terrorism drill where we will perform "drive-by" immunizations of thousands of police officers and fire fighters. (And we have to be deputized to do this. Yes!) We also have the opportunity to volunteer for free tattoo removal and/or perinatal education for low-income families. As a part of our concurrent L&D rotation, we have 12 hours on the floor, and the option to volunteer in the NICU or at the Women's Option Center. That, and a pretty laid back academic quarter, makes us all happy.
Tuberculosis, methicillin-resistant staphylococcus aureus, acute colitis, cystic fibrosis, cancer, renal failure, necrotizing fasciitis, acute lymphatic leukemia, pneumonia, paralysis secondary to lumbar laminectomy, abscessed abdominal incision with wound vac, inflammation of the terminal ileum secondary to Chron’s disease, herniated intestine causing malnutrition, muscular sclerosis with secondary decubitus ulceration of the bony prominences, dementia, liver failure, more TB, more cancer, more CF, staph infection secondary to hip replacement accompanied by cirrhosis, undiagnosed, undiagnosed, undiagnosed…welcome to general medicine, week 5!
Maybe it's like the erotic zone and/or the Twilight Zone, but I am still trying to figure out why the men in our cohort felt compelled to don the female genitalia for catheter insertion* in clinical skills lab on Tuesday.
Studying for the last pathophysiology exam I read this: MI --> reduced CO --> dilation of heart --> increased pathway length for conduction --> allow impulse to re-enter muscle that is recovering refractoriness --> increased potential for circus movements --> VT
Unofficially, I began clinical rotations last week. Yesterday I began working, officially. I'm at a tertiary hospital for eight hour shifts. At the moment, all of the MEPNs are shadowing nurse's aids, arguably the hardest working people in the hospital. The NA that I shadowed yesterday not only works an 8 hour day shift on one of the busiest floors of the hospital, but travels 30 miles to a skilled nursing facility where she works another 8 hour shift, 5 days per week. She was humble, informative, hard working, compassionate. As we were charting at the end of the day, we were looking through the chart at patient diagnoses. "Read this," she said of the doctor's notes, "you'll need to know it." If I had a diagnostic question, she'd answer it. As it turns out, she was licensed and practiced as an RN in Manila. She's now practicing at home (in her spare time, whenever that can possibly be) to take the NCLEX here in California. And that, my friends, is much, much harder work than MEPN.
Yesterday marked the end of week one for MEPN. We celebrated with team-building activities in Golden Gate Park. One of the more fascinating exercises was that in which an imaginary world map was drawn on the surface of the field -- with China stage left, Europe stage right*. The leader of the group from UCSF's own outdoor program represented Alaska, as a point of reference. The idea was for each student to place him/herself in his or her hometown/city of birth.MEPN started this week and I've hardly had the chance to breathe. I've kind of felt like this.
I've had some inquiries about getting into MEPN, as in, how the heck that works. To be honest, I have no idea. But I can give a simple synopsis of my own history; maybe it will help in some way. Here it is, abridged. I have significant hands-on health care experience, though it is rather ancient (we're talking twelve years past). Because of this, any volunteer or health related jobs I held in the interim, I mentioned in my application. I have a graduate degree in a related field, a few publications under my belt, some first-authored and some in medical journals, and -- this came up again and again on interview day and in conversations with faculty -- I have experience and expertise in a particular area. That is to say, I have access and demonstrated commitment to a particular community. Having worked in reproductive technologies and women's health for about ten years may have been the single deciding factor in my entry to the advanced practice perinatal nursing specialty. As for the initial decision, GPA and GRE scores are kind of like the limbo bar: if you make it under, you go on to the next round. It seems that both the statement of purpose and (strong) letters of recommendation focusing on your proposed area/community are imperative. Beyond that, as far as I can tell, it's a total crap shoot.
Having spent many years in research, negotiating the anti-collegial evil eye of the academe that initially accompanied my choice to go clinical was not easy. What better way to begin the transition than with this image? It's me! (The black nurse-cape is crucial to my transformation.)
