Today I just registered for my last semester here at Hopkins SON.  It’s hard to believe almost 2 years has gone by and that in May I will have graduated. At this time I am so unsure of what to do after May.  One of the best things about nursing is it has so much diversity.  There are so many options out there.  Since I will have my NP in family medicine the possibilities are endless, which makes it very daunting when trying to choose a career path. I can see patients all along the lifespan and even specialize or stay in primary care if I choose. Eventually as I have mentioned before I really would like to do international work.  But do I get some experience here first? Or go right into that?  I’m applying for the MHIRT program to be able to experience international medicine. I have traveled internationally plenty of times but it has all been for vacation. (On a side note: I actually recently was in Puerto Vallarta, Mexico for my best friend’s wedding.  Got to practice my Spanish that I have been working on this semester!  I had a great time!)  I’m really hoping to be chosen for the program in order to be able to experience it…I’m very excited! I’m going to send my resume out to organizations to WHO and Doctors without Boarders and see what happens, you never know.

 

Another semester is winding down, which means I have 2 papers and a presentation to work on yet.  I’m almost done with my clinic hours so that will free up my time a bit.  I’m looking forward to Thanksgiving.  Since I am unable to take time to drive up to see my family, they are coming to my house this year for dinner.  I can’t wait!

Well I seriously was slacking in by blog posting for the summer.  Here it is the last week before finals and I’m finally posting a blog.  Probably because I had to cram everything in to 10 weeks!! Yes, I only had 7 credits, but as you know grad credits seem to have more work involved with them.  On top of that I also had another 196 hours of clinical to complete. The amount of work involved in this semester was intense to say the least.  Besides my usual patient write ups which I had to do just about every week, there was a 30 page State of the Science paper, among others, I had to do for research class….yea don’t even ask!  But if you must know, it was a literature review/critique, implementaion of evidence based practice, and ideas for future research of airway pressure release ventilation in acute respiratory distress syndrome. Now aren't you glad you asked?!

I had my adult rotation this semester.  My clinical sites were at long-term care facilities and in a hematologist/oncologist office where I got to see out and inpatients.  I had a real broad range of medicine between the 2 and both were very interesting. In the long-term care I was amazed by the autonomy the NP had!  It’s actually a little daunting knowing you’re the one making the decisions on how to treat the patient.  There is always an attending physician to call but you’re the first line!

 At least I had a 3 week break before classes started for the summer…so I got a little bit of a break.  I went to Colorado then off to California where I spent some serious time on the beach!  I have another break the end of August so I hear the beach calling my name again!

Finals here I come!

As I sit here in Panera, ready to continue and tackle my 13 page take home mid-term…I decided that I really need to get on with writing another blog.  A couple of my fellow bloggers have asked me a couple of questions during our meetings (and I was asking them because I was stuck on what to write about).  They asked, before continuing on to get your MSN and become a nurse practitioner, is it best to get out there after nursing school and get some experience first?  Now granted, I’m coming from the “experienced” side but I have observed a couple of things from those who are in my class with no nursing experience. 

To be experienced… As I have said before I have about 5 years of critical care experience ranging from ER to ICU.  I always want to get out and do the nursing thing before going on for my MSN, but I didn’t want to wait too long.  My experience has definitely helped me during my course here so far.  I have called upon the knowledge, skills, and critical thinking I have learned many times for tests and clinical experiences.  But my experience and knowledge only goes so far in that, like in my previous blog, I have absolutely no idea what to do with children.  In that aspect, I have no experience and I fell like a new grad.  In my first clinical with adults (something I am confident in) my preceptor kept telling me to think “practitioner” not “nurse”.  So there is a difference.  During the initial exam, deciding what is emergent, what is not, getting the patient’s history, and doing your physical exam, a lot of it is the same. But as a practitioner, you are thinking, differential diagnoses. You are going through them thinking what supports this and what rules some out, what tests should I do to support my thinking.  Then you go through possible treatments.  I know nurses do this as well…be we anticipate the treatment.  Trust me it’s a bit daunting when you’re the one who makes the final decision! All in all, I fell better that I do have experience to call upon.  It gives the confidence I need and I rest in the fact that I have been through this before where I felt like I have no idea what I’m doing but it will all come to me in time.

Not to be… Those who have gone right into the MSN program from their nursing undergrad do have the upper hand in some aspects.  They haven’t taken a “break” from school.  They still have that study mentality and remember how to write 10 page papers.  Trust me, when you go out and make money and can go out every night of the week and not have a test to study for…it VERY hard to give that up and go back to sitting in front of a book every night and living off student loans…again!  They also don’t need to be told “think like a nurse practitioner, not nurse”.  They are going into this fresh and their minds are open.  They can be taught to think like this. It is hard to transition your roles in the profession.

So with that said, I guess it’s up to you.  I’m glad I went out there and did it and saw what areas I am interested in.  I very much enjoyed being a nurse and I always will be no matter what.  Guess that’s what sets us apart from physicians.

I decided to take a break from studying for my next final I have to take today and write in my blog since I have seriously been slacking. I do have to say it been tough to reflect on my thoughts in between having presentations to work on and 7 (yes that would be seven finals I must take in one week) to study for.  So I figured while I'm sitting here in the NIRC cramming for final #3, I would take a much needed breather.

On the one day I was able to visit my family up in PA for Thanksgiving...I was sitting and working on my patho presentation, which was on endocarditis, my mother peers over and reads my power point.  She exclaims, "Wow, this is like another language to me!!"  She has said this on multiple occasions when I chat with her about school and work.  

As medical professionals, we must keep in mind that medical terminology is "another language" to the layman.  It is a necessary language to learn while in school to be able to convey your findings or actions in documentation and to other colleagues.   But it is the layman we must keep in mind.  The layman is our patients and our patients' families.  We must be able to "translate" medical terminology to them.  There have been so many times when I have been in the room when a doctor came to inform the patient or the family of their status/condition.  Sometimes they don't even realize the jargon that they are throwing at them.  On top of this, these people are usually in some state of disbelief, shock, and stress over their condition and only hear about half of that to begin with.  So many times the doctor has left the room and I ask the family if they understood or have any other questions and they have no idea what he/she had just said.  When talking with the layman, don't feel as though you are talking down to them.  Think of it as translation.  You speak a language they don't know and you must translate to one they do.  Before you came to nursing school how many of you knew what emesis was? Myocardial infarction? Or toxic epithelial necrosis?  Right...so how do you expect your patient to know?  Mrs. Jones to you vomit at any time today?  Have you ever had a heart attack in the past?  Mr. Jones, your wife is having a severe skin reaction to one of the medications she has taken.  See doesn't that sound better.

So, as one of your nursing/practitioner roles you may add bilingual and translator.  Remember to always keep in mind the layman because to them you are speaking another language.

So...here I am 8 weeks into the MSN/FNP program.  Midterms have just ended (whew!) except for the take home midterm I'm working on at this moment.  I can say graduate work is definitely different then undergrad nursing school.  Besides being much more difficult, which you expect grad work to be, I do notice the professional way you are treated by instructors and speakers alike.  So far I'm greatly enjoying my program and I'm looking forward to getting into the more clinical aspect of it.  Right now it’s mainly the core classes I'm taking.  Focus for this semester....the basics such as patho, pharm, assessment, and management with the clinical aspect focused on obtaining a good health history from the patient.  History being 80% of your diagnosis, or so they keep telling us in class and I definitely believe!

For a bit about me (being my first blog) Working on top of going to school full time has defiantly been a challenge so far.  Next semester I really need to cut down my working hours!  I am a critical care nurse (ICU/ER) and I have been for 4 1/2 years.  The nursing experience has helped me in putting things together when learning the material. I went the long way around in my education by...getting my AD in nursing....working...doing the online thing at U of MD and getting my BSN...working...and now here I am.  I knew I always wanted to be a NP, but as you all know money comes as an issue and I wanted experience first.  I do want to take my practice internationally but not sure where yet or what to specialize in or to keep it general.  Time will tell.

All in all I feel privileged to be here.  Sometimes, during my lectures from guest speakers, I sit there and think, WOW I'm hearing this information from some of the best practitioners in this field!  And that’s just a bonus so far as to why I choose to come here.