All nursing school, all the time

Returning to the abandoned blog. It's been busy, although less stressful than last year, I think. Somehow we're already over halfway through the semester and I'll be done with this program in 7 months. The supposed class from hell, Complex Health Alterations, has proven to be not all that bad, as long as I do the reading. My lazy ass has managed to get it together enough to do quite well, which has been a nice surprise.

Clinicals have been a million times better than they were last year. Especially during first semester, I dreaded clinicals. I was thrilled when they were done for the semester. But we've had several weeks of them now and they haven't been too bad. Okay, I should clarify that. We finished our acute care/med-surg clinical last week and, apart from the pain-in-the-ass-ness of having to go to a hospital over an hour away and be gone for two nights a week, it was great. Learned a lot, got called "an angel" (HA!) by a patient, got to start my first IV. It was a successful start on the first try, but it wasn't a particularly proud moment. Mainly because once I got it into the vein, I started shaking and completely forgot what to do next, and ended up with blood on the floor. Hey, it happens. The very nice RN who was overseeing me quickly took over and got the saline lock on, and I taped it up. This clinical really was a good experience overall.

Now we're in mental health, and I'm surprised at how much I don't like it. It's not like last year, I don't dread going back next week and I'm learning a lot, but it's getting to me. It's hard to go home and set it aside, and I haven't been able to do it. I just keep thinking about it. It's kind of horrifying to be faced with live evidence of just how much psychological damage one person can inflict on another human being.

Before we started this rotation, I thought I would really like it and might be interested in working in it for a while, but not so much. I think you have to have a certain combination of empathy, excellent communication skills, and an ability to care about what happens to people, but not too much--be dispassionate. I can do empathy, I can do communication, but I have a hard time with the dispassion. It's probably something I should work on in general, but I doubt I'll ever get it enough to work in mental health.

A little thing called empathy, and how it seems to be in short supply these days

Let's talk about health care for a minute.

I'm one of the 50 million uninsured. I'm not an illegal immigrant*, nor am I a welfare queen with increasing numbers of children to collect my ill-gotten government spoils (psst, by the way, all those welfare queens live with unicorns and leprechauns and gay agenda recruiters in the fevered land of Conservative Imagination), nor am I a shiftless substance abuser who spends all day on her Play Station. I'm a nursing student who is working hard to get through school so I can get a job that will provide health insurance, most likely at outrageous premiums. By this time next year, I should have health care coverage and no longer have to live in fear of injuring myself or finding a lump in my breast. But until then, I'm shit out of luck, a point that was hammered home three weeks ago when I developed an abscess in my throat.

An abscess is a pocket of infection. It can develop anywhere in the body as a result of trauma, illness, or the whims of the gods. Mine was the latter; I hadn't been sick until I woke up with a swollen throat and pressure in my sinuses. Within 18 hours the pain was so bad I had Kevin drive me to the ER. Now, I'm no dummy, I knew this would cost me. I'm also no big fan of using the ER for non-emergencies, but it was 2 AM and I was in incredible pain. I was hoping for strep so I could get antibiotics and clear it up, but the rapid test came back negative and the doctor told me it was most likely viral, gave me a couple of Vicodin for the pain, and sent me home. Time spent from check-in to discharge: 25 minutes. Tally of procedures done: vital signs, strep culture, ear nose and throat assessment, the ubiquitous tapping of sinuses, and administration of 2 Vicodin by mouth. Tally of money owed by me to the hospital at this point: $800.

36 hours later, my throat is worse--it's so swollen it looks like a mushy red ping pong ball back there and I have to psych myself up each time I need to swallow. I'm taking painkillers around the clock. The one community clinic for uninsured and low-income patients (aside from the tribal clinics, which are excellent but serve specific populations only) in the area, which is 25 miles away, can't get me in, so we go back to the hospital to go to their walk-in clinic. Instead of the walk-in clinic, I get triaged back into the ER and I'm hoping this time the strep test will be positive so I don't look like a big baby who can't wait out the virus. Nobody rolls their eyes or calls me a baby. The doctor takes one look in my throat, becomes visibly alarmed, and orders a complete blood count and a CT scan with contrast. The cost of this concerns me until I get a shot of morphine. They start an IV, poke and prod me, flood me with dye that makes it feel like I've just peed myself, and scan my head and neck. This time, I'm there for 2 hours and they flirt with the idea of sending me by ambulance to Duluth for surgery, at which point not even morphine can keep my brain from flipping back to what little I know about the procedure of declaring bankruptcy. They consult by phone with the ENT specialist in Duluth, who thinks it's fine if I just come and see him in his office in the morning. Fortunately, when we show up there the next day, he declares the CT scan results "impressive" but thinks it can be cleared up with some heavy-duty antibiotics and surgery isn't necessary. I can't even tally the procedures done, but I did get IV antibiotics and steroids for the swelling, the CT scan, blood tests, morphine, and some other stuff. Total for this ER visit: just shy of $3000. Total for the 20 minutes I spent with the ENT specialist in Duluth while he looked in my throat and checked out the CD of my scan: $176. 

So you're probably thinking, well, those scans and ER visits are expensive, everyone knows that. True. But since people who have insurance often don't see an itemized bill of their medical visits (and insurance often negotiates for more reasonable fees than we uninsured schmucks have to pay), you might be interested to see how those charges add up. For example, just for walking into the ER with a "mod/high severity" problem, I was charged $325.80. Throw in a doctor to see me at that level and it's another $386.40. And my personal favorite, when I got that shot of morphine, it cost $109.60. Not including the morphine. Just getting the injection cost that much. If I'd have known that, I could have done it myself and I wouldn't have even charged them. Hell, starting the IV only cost half that, which makes no sense since it's a much more skilled task. I think the nurses' union should really be pushing for a cut of this, cause that nurse earned the hospital over $150 for less than five minutes worth of work.

Now, here's the thing that really chapped my ass and made me finally get around to writing this little autobiography/tirade (the tirade's on its way, in case you were wondering). I got yet another bill the other day for the services of a radiologist, for $266. You might think those services would be included in the $1115.75 the hospital's charging me for the CT scan, but you would be wrong. I called the billing person to ask about the bill, saying I had a question about it. She immediately starts firing questions at me about how I'm going to pay for it--Visa or MasterCard? I finally get a chance to break in and ask if I can ask my own question and she graciously allows it, so I tell her I'm unclear as to what the bill is for. She said it was for the person who read the scan. 

Okay. Here's the deal: the doctor in the ER told me I had a peritonsillar abscess. As I found out the next day from the specialist in Duluth, this was not possible, as I haven't had tonsils since I was eight. I did have an abscess and it was in my throat, but placement matters. It matters to potential airway restriction, it matters to whether or not the abscess can spread into other areas, like, oh, maybe your brain (and I realize that sounds like a scare-mongering urban myth but my brother had a friend and co-worker die of such a thing and I would rather not die from something so preventable, thanks). So if, in fact, there was a radiologist on duty who passed that information on to the ER doc (a question in and of itself as it was after hours), he didn't really know what the fuck he was talking about. So I get to pay $266 for some incompetent baseless speculation, which obviously thrills me to no end.

So now all of this ER excitement and billing madness is of course going on at the same time as these heated healthcare debates. And you know what? I'm sitting here looking at over $4000 in medical bills, which is really nothing compared to what it could have been and what a lot of other people have to deal with it, and I DON'T WANT TO FUCKING HEAR ANY MORE OF THIS RIDICULOUS "SOCIALISM" FEAR-MONGERING BULLSHIT. Health care that doesn't bankrupt people is not supposed to be a special treat for a lucky few, and it shouldn't be set aside as a privilege for those lucky enough to have a decent job that offers decent health insurance. Making sure everyone in our country can get and afford health care is not socialism or fascism (and, little tip to crazy screaming people who think only some people deserve health care--socialism is the polar opposite of fascism. Read up on some basic political theory before you get too wild-eyed to read anything). It is called taking care of your community. 

Worried about your taxes going up? To be honest, yes, they probably would go up with single-payer health care coverage, which is the system that Canada has. But consider for just a minute how much you pay in monthly premiums for your health insurance coverage through your employer, assuming you're lucky enough to have health coverage. When Kevin and I did have insurance, we paid $300 a month to cover both of us under his plan, and that is not at all unusually high. $3600 a year, while we were making around 35-40K a year between the two of us. That's 10% of our income! Do you honestly believe that taxes for the average family, simply for health care coverage, would be $3600 a year if we had a single-payer system? You might, and if you do, you've probably fully convinced yourself and I should just leave you to drawing Hitler mustaches on pictures of Obama. But for the rest of you, really stop and think about it. Think about how many people Medicare covers right now, and look at the amount of money taken out of your paycheck for that, then use your head and apply some critical thinking skills.

So numbers are fine, but for me, I just don't like the fact that so many of us think it's perfectly okay that someone can get prostate cancer and his friends have to hold a bake sale to pay for his chemo. I don't like the fact that someone having a heart attack may not just be terrified about whether or not she's going to live, but whether or not this is going to cost her her house. I don't like it. I'm not working my ass off to become a nurse because I think only certain people deserve to be treated without having to worry about how they're going to come up with the money to pay for it. Nobody gets sick on purpose. Throw around all the value judgments you want about obesity and health care costs, but marathon runners have heart attacks too. Yes, we all have an obligation to ourselves and our loved ones to do what we can to take care of ourselves, but the fact of the matter is, sometimes illness and injuries just happen, and it's out of our control, and we all deserve to be able to focus on healing without worrying about finding a decent bankruptcy lawyer.

*For what it's worth, I have no problem with undocumented immigrants, but I know there is much hysteria about OMG those people don't even belong here and they can just waltz into any of OUR hospitals and get emergency health care?!! This is another topic entirely and one that I don't care to get into right now, but let me just say that if you think someone should be allowed to bleed to death because they snuck into this country illegally because it's the only way they could earn any money to feed their family, you are missing a serious chunk of your humanity. That goes double if you call yourself a Christian. 

Radio hasn't been any good since Clear Channel anyway

Hi there. I'm paranoid and insecure. How are you?

A while ago I was reading every piece of non-fiction that Anne Lamott wrote, and I came across a particularly brilliant section discussing our own capacity to sabotage ourselves. She had a nickname for the constant yammering that goes on in our heads sometimes, criticizing and nitpicking and pointing out our general suckiness and lack of worth. It's the radio station known as KFKD, or K-Fucked. 

KFKD's been getting a lot of airtime these days. My own personal version features an endless loop of "Nobody really likes you", "You did it wrong, again", "Your capacity for lameness is never-ending" and "Come On Eileen". I can't stand "Come On Eileen".

I'm exaggerating, slightly (but not about "Come On Eileen"--that song blows). KFKD's definitely been blasting the airwaves, but it's not quite that bad. I think my capacity for lameness does have limits. But my insecurity annoys me. And my capacity for tearing myself down actually doesn't seem to have limits. 

What I'm about to say isn't earth-shattering. I've seen it in several feminist-leaning blogs of late. But I think it bears repeating, over and over and over, until it finally starts to sink in. When I step back and look at all the crappy thoughts I have about myself, then imagine having those thoughts about a friend, I'm kind of horrified. I would never look at a friend and say, "Wow, your arms look enormous in that shirt. And you're not half as interesting as you think you are. And no one really likes you. I'm amazed you think anyone does." But apparently, I'm perfectly willing to direct that kind of abusive garbage at myself, if only mentally.  And that's kind of sick. 

KFKD sucks. It's the worst radio station ever, and that's even without having to listen to Casey Kasem and ads for monster truck rallies (We'll sell you the whole seat, but you'll only need the edge!). I wish the FCC would slap a humongous fine on it and shut it down, because I can't always figure out how to just turn it off. Maybe I can drown it out with The Soviettes or something. Or maybe I can slowly inch down the volume until it finally goes away.

We don't need no stinkin' air conditioner

Why yes it has been five weeks since I wrote last. I'm not happy with the quality of the stuff I've been writing lately, so I just kind of abandoned it for a while. Because everyone knows the best way to get better at something is not to do it, and then you will magically improve.

Summer is finally here; it's in the 80s and sunny today. No small feat when you realize it was in the 40s two weeks ago. We don't have normal seasons like the rest of the country. We have a short, pleasant fall, a freakishly long sunless winter, and a drawn-out spring. Then we get a couple of months of summer, and everyone loses their fucking minds. It's so gorgeous here in the summer, which is the whole reason most of us live here, and there's like this crazy energy, everyone trying to cram in as much as they possibly can before it starts getting cold again.

My internship is great, I wish I could just stay there. I'm learning a ton about the tribal culture and hoping to pick up a few more Ojibwe words before the summer ends, and meeting some really cool people. Plus I get to do so much community nurse networking and research, which is such a benefit, career-wise.

I'm thinking again about becoming a midwife. I had kind of shoved the idea aside after I realized no way in hell would I want a job that keeps me on call 24-7. But if there were a possibility of some kind of practice with other nurse midwives, maybe even a birth center, well, damn, why not? It becomes a lot more appealing when that enters the equation, and it's definitely not out of the question. I have a couple of years to decide, but I'm starting to get kind of excited about the idea.

Finally, Kevin and I had our third anniversary a couple of weeks ago. It doesn't seem like three years. I actually get a little spooked when I think about how fast time is going by. Still, three years ain't bad. And all of that stuff about marriage being hard work is bullshit. It's only hard work if you find it difficult to put a little effort into appreciating your spouse, communicating openly, showing love and affection, and maintaining a baseline of consideration for each other. Yeah, yeah, yeah, sometimes it requires more, but essentially, that's it and you're good. So suck it, Dr. Phil.


P.S. I chopped all my hair off. I'm officially resigning myself to getting only basic haircuts here and finishing them myself. My too-long "pixie" cut became distinctly helmet-y in less than three weeks, so I took a pair of nail scissors to it and am much happier now.

Is laziness a symptom of sunstroke?

I should really be studying for my last exam right now, but dammit, I spent the morning eating cinnamon rolls and drinking coffee with three of my fellow students out on our brand new deck under the pretense of going over our group project, and nothing will kill your motivation to memorize vaccination schedules and childhood disease like the combination of sunshine, caffeine and 4000 grams of sugar. You'd think it would be the opposite, right? It's not.

It's hard to believe the first year of school is over. I'm halfway done! I'm pretty much completely dreading this fall, as third semester seems to be the most hellacious, according to everyone who's been through it. I do love being in school, but that's not to say that there's not a ton of bullshit that comes along with it, and it often makes me pissy. I'm happy to have my internship this summer and I'm hoping that I'll love it so much that it will keep me motivated through the next year. That might be a tall order.

On an entirely different note, I'm debating chopping my hair off again. I want to go back to the pixie cut I had my last summer in Boston. It was freaking adorable. I had one picture of myself during that time; it was on my old laptop and it failed to occur to this idiot to save it to my flash drive when I wiped my hard drive clean. So you'll just have to take my word for it.

Dog and Pony Show

So, like just about everyone else with a blog and two sentences to string together, I want to write about Susan Boyle. Susan Boyle, she of the unkempt eyebrows and stunning vocal talent, who has been all over the news this week for, apparently, shocking the hell out of everyone with the news that physically "unattractive" people aren't totally worthless.

There are a number of approaches to take with this story. This is a really great piece about how satisfying it is to watch all of those rude, smug, eyerolling motherfuckers have those smirks wiped right off their faces as soon as she opens her mouth. And there is a lot of truth to that, and she's right, there's something very inspirational about watching it happen.

But here's what's chapping my ass about this story: the fact that international news has been made by the idea that this woman is an "unlikely talent" because she isn't pretty and she's older and she's kind of awkward. In some of the news coverage, she's presented as something akin to a dog that can do trigonometry, like some kind of astonishing conundrum. Which is so unbelievably offensive and such a depressing statement on what we as a society value and how we make snap judgments on the worth of another human being.

The fact that all of those people were scoffing at Susan Boyle, ready to dismiss her without hearing one single note of her singing is fucking gross. And not one of those judges, who were rolling their eyes and reacting in exactly the same way as the teenage mean girls in the audience before she started singing, expressed any shame at their shallow judgment of her; their comments after the song all equate to, "Wow, good for you for having something so amazing to offer, who'd have guessed."

I guess success is the best revenge and it's not like anyone would actually expect any of those shallow tools to engage in anything approximating serious soul-searching, but it would be nice to see some kind of reflection on why this story has become international news. It says so much more about our values than it does about Susan Boyle. But in any case, I hope she becomes incredibly rich and famous and stays true to herself, and only waxes her eyebrows if it's what she really wants to do.

Hot DAMN!

I was informed today that I got the summer internship that I desperately wanted. I was getting all set for disappointment, because that's what usually happens, then, wham, one cheery phone call from Madison later and I'm all set up. It's an amazing internship, as seen below in bulletpoints.

• maternal/child public health at the reservation clinic
  
• working with a photography project on parental support systems
  
• a super-cool mentor
  
• paid

I'm so excited, I may wet myself. Lord knows how I'll hold out for the next two months before it starts.

Chart-toppin' hair

I got a haircut a couple of weeks ago.

Let me preface all of this by saying that I am extremely picky about my hair, but not in the way that most girls are. I will go from having hair below my shoulders to a pixie cut without a second thought. I don't understand people who fret about whether they should risk dying their hair at home--I have handed over a large amount of money to the L'Oreal corporation throughout the years, along with Clairol and whoever owns Manic Panic now. I have cut my own hair on many occasions and the only thing that stops me from doing that all the time is that it doesn't look good for as long as a professional cut--but it's kickass for a good week or so. I'm picky in that I want it choppier than almost anyone will give me and I want an interesting haircut and I fucking hate it when they insist on blow-drying it with a round brush. The best haircut I ever had was last year when I went to this punk rock girl and told her to give me any kind of short haircut she wanted.

So, anyway, a couple of weeks ago I got what was supposed to be this haircut:


Which is adorable. And in theory, it's a very similar haircut. She actually listened when I told her my hair is deceptively thick and she razored the hell out of it. But I don't know if it's that my hair just won't do this or she cut it a little too short or I'm just not cute enough for this cut, because it's not working out. I will have it looking acceptable in the morning before I leave the house, then I'll run to the bathroom after a couple of hours of class and, oh, look, there's Pat Nixon.


Which is horrifying and also defies understanding, because Pat looks like she had some seriously high-maintenance hair. How is it that a couple of hours spent on something other than tending to my hairstyle leaves me with a Republican Helmet Coif?

I'm hoping that a couple of weeks of growth will solve this problem. Thank all that is holy, it's already outgrown the default it had for the first week or so, where I looked like I was just about to go grab myself a Bartles & Jaymes and order my 6-year-old to the Seven-'Leven to pick up a couple packs of Kools. At least it makes a cute ponytail.

Rebel Girl

Last night Kevin and I watched Don't Need You: The Herstory of Riot Grrrl. It was a little thin and it was obvious that it was someone's college project, but it was interesting nonetheless. Ian MacKaye of Fugazi/Minor Threat/general-pain-in-the-ass fame earned my everlasting disgust by moronically saying, "I don't really consider myself a feminist; that's probably due to a lack of reading about the subject." Dude, you get up on your high fucking horse about every social issue that exists, but you can't be bothered to learn about one of the most important social movements of the last century? Screw you.

Watching it got me thinking about what I was doing during the whole early-mid-nineties riot grrl/punk revival thing that was going on. Looking back, I can't believe I didn't embrace it with wild abandon. I was a feminist before I was brave enough to call myself one, I had definite punk rock sensibilities, I read Sassy, for christ's sake. But I didn't know where to start and I was always, always too intimidated to join in; the people were so much cooler than me. I've never really gotten over that. I still feel like it's the cool kids table and I'm waaay too dorky to try and set my tray down.

Kathleen Hanna's interview was so great, because she was so normal and adorable and talked about how scared she got when things got out of control at Bikini Kill shows. And so much of what she said just resonated, like when she was saying she could never stand to hear her own voice and still can barely listen to her albums, and how that seems to be such a common thing for girls. And, yeah, why is that? Why do we have that problem? Let's collectively knock it off, shall we?

I wish it hadn't taken me until my mid-twenties to grow enough of a pair to start exploring this stuff. I wish I had spent more time making art and writing and DOING something instead of watching lame TV. I hope I'm able to get over the idea that I'm too old now and start fitting this stuff in a little more than I have been.

procrastiwhining

I should really be working on a care plan right now. It's not due til the 9th, but it would be really nice to get it in early. But spending the morning hanging out in the local coffee shop plus a snowstorm, which always makes me feel really lazy, has left me disinclined to do much more than poke around on the Internet, where apparently everyone is pregnant or has a gorgeous new baby.

So, okay. Objectively, it is really good to not have children while we're in school. It makes things so much easier, and I know this. Believe me, I know this. But. It's getting really really hard to see all of these people I know who are pregnant and having kids left and right. I'm super happy for all of them, I really am. I've put a lot of effort into not turning into someone who resents those who get pregnant at the drop of a condom or already have the family they want. I'm thrilled that people I care about are happy.

I don't idealize parenthood, by any means. I know it often sucks and is beyond hard. I've seen the screeching tantrums in the grocery store. That's not the point. It's deeper than that and impossible to explain to someone who doesn't already know what it's like. I don't really expect anyone to get it otherwise; I certainly wouldn't have. I try to let the stupid comments roll off my back, unless they're just really blindingly ignorant.

Frankly, sometimes I'm glad we don't have anyone to take care of, like when I was sick last week. Sometimes I don't think about it at all. But a lot of the time, it just feels so glaringly obvious that something's missing.

Cognitive dissonance

I went out with some friends from school last night. We were supposed to see some band called Shotgun Betsy, which was supposed to be three women who do Hank III covers and such. But it was the wrong night and apparently the band is three dudes, not women. So we sat in the bar and drank beer and played Bonnie Tyler and Pat Benatar on the jukebox. It probably ended up being a better time than it would have been had the band been playing, because my friends are a lot of fun and interesting to talk to and one of the reasons I like school so much. Still, when they mentioned a party tonight, I said "Eh, I don't know, two nights in a row?"

A few minutes later I said, "If you had told me seven years ago that I would be turning down an invitation to a party on Saturday night to sit at home in my yoga pants and watch TV, I would have told you to fuck off." Yes, I am becoming old and tired. And I'm not sure how I feel about that. On the one hand, I couldn't care less because my lazy hibernation impulse has become an overwhelming force. On the other hand, I miss the days when all I did was go out and all I wanted to do was go out.

On yet another hand, I'm not sure what to think about the fact that the time of my life when I was socializing the most and having the most fun, a time that I remember with a great deal of fondness and nostalgia, was also the most traumatic and tragic time I ever hope to experience. And now that I'm at my most boring, I'm also at my most content. Maybe that's the key.

When your fantasies turn into "Helter Skelter"

Oh, Joaquin. You were at the top of my "No Questions Asked" list (the list of people I could have an affair with, no questions asked. Kevin disagrees with the theory behind the list but I figure we can cross that bridge when we get to it). But you'll have to take care of this Charles Manson thing you've got going on right now before we can get it on, my friend. You can use this as a guideline:



See? Look how nice you clean up. Go on, shave off that beard and quit acting all crazy-like, then come give mama some sugar.

Blargh post

I have been wanting to write, I have stuff to say, but I'm exhausted and over-worked beyond all reason at the moment and can't even really justify the time spent on this little whine. This is the week from hell and I had to exercise all of my "Oh no you di-int" muscles last night when a fellow student finally crossed the laziness tolerance line (which I don't do unless pushed really really far-- I'm Not Always Nice, but I don't do a lot of confrontation, as most people familiar with me know), and I'm counting down the hours until I get a chance to drink an extra glass of wine.

Just, ugh.

Currently the sweetest phrase in the English language:

Former President George W. Bush.

Home is..flattened by bulldozers

This is a picture of the house I grew up in. My parents bought it when I was a year old and they just sold it last summer. Next door to the house is a cemetery, and it was actually the cemetery association who bought it (heh, "cemetery" and "bought it" in the same sentence). Obviously, they're not in need of the house, so they tore it down last fall. Kevin and I drove out to take a look at it when we were in the Cities last month. This is what it looks like now:


It broke my heart a little--I loved that house so much. But I can't tell whether it would be better if they had sold it to a family, to have some strangers living in it, possibly doing awful things like installing track lighting and putting up Grandma-Bending-Over lawn art. Either way, it's a very strange feeling to know that I really, really really can't go home again.