Americuh!

So I've been partaking of a friend's generosity in the form of a shared Netflix account and so far I've been plundering the documentary listings with regularity that would make any senior's bowels go green with envy.

How's that for an opening? I should just quit now.

A couple of these documentaries have depicted the American healthcare system in varying capacities: as the focus of the story, a minor subplot, even a plot device. Now, I really try not to take many solid cues from the media as it just never feels quite right to accept something that has been influenced by many forces before the finished product (and all its missing pieces) gets presented to me. It (media) actually has begun to offend my sensibilities and now I get disgruntled because I can't check source references or know that the story was published objectively by a peer-reviewed entity.  So much communication contains, relies upon, and is sustained by misinformation that it is very difficult to differentiate and I know I'm just beginning to learn.

I digress...

Suffice it to say that, personally, I know the American system and its inner-workings VERY loosely and have no first-hand experience with how it functions; so, if we could keep that disclaimer at the back of our minds, I'll continue.

It breaks my heart.

I wanted to insert profanity here for emphasis but I'll let my yes be yes.

Now the explanation.

I don't understand a lot of things about the US system.  For instance, I don't understand how people have to make a choice between seeing a doctor and paying their rent.  I also don't understand how a family with a paranoid schizophrenic child suffering an acute episode has to first call a customer service wonk from their insurance to see which hospital they're allowed to go to and for how long their child can stay before they will no longer be covered.  I don't get how nurses are (forced?) told to discharge patients who have no coverage or means to pay for treatment.  I don't get how a serious illness or serious trauma can result in the remortgaging of your house or the seizure of your house because you had to use it as collateral for your ballooning hospital bills and now you can't pay because you're sick.  I don't understand how being sick precludes you from receiving coverage that would help you to stop being sick.

I guess overall I don't get how the issue of money runs even with the state of health of the individual.

I come from a far away land where we have different way of doing things and dammit if we don't have our own injustices and problems to work out.  Please don't mistake this for an argument whereby I'm just asking why the US doesn't just do what we do; I mean, they should, but that's rather trite.

I am on my way to becoming a registered nurse in this country and I'm getting somewhat excited to get done with school and get back out working again. My excitement is buoyed by the healthcare system that I will be representing because I know that the number one priority is to be the patient and the health of the people as a whole. However, as I get more and more glimpses into the US system, I have realized that there exists a situation where I would walk away from my profession because I couldn't reconcile my actions with my thoughts.

You get paid as a nurse...

 

...and this is great; but what happens when you don't believe in/agree with the system you represent?  What would you do?

This is what keeps bothering me.  Obviously people raised in the the US will be acclimatized to their healthcare system and some will end up working there as nurses.  No big deal.  But then I keep hearing (constantly) about how Canadian nurses are flocking to the US and the reasons vary slightly but they ALWAYS contain more money. Chalk it up to personality differences but I'd rather sodomize myself daily with a roll of newspaper articles bemoaning Canadian ED wait times than have to look a patient (NOT a client, customer, or guest) in the eye and tell them I could no longer treat them because their coverage had run out and accounts recievable hospital policy says they have to leave.

That's what it comes down to for me.  If being a nurse means prioritizing money ahead of the patient's needs then I'm done....I'm out.

I will be the first to admit that I am naive about a great many things and this goes doubly for nursing.  What I always want and need is a little perspective, a little learnin'.  No better way to do that than asking questions and listening with your mouth closed.  Come at me!

From Hell...

So, the stars finally aligned and I have come across the legendary "clinical instructor from hell".  The one that doesn't listen, is always right, thinks positivity is simply an electrical charge, threatens you with learning contracts and failure on a daily basis but only when he/she isn't berating you in front of your patients, their family, or other nurses.

We've all had one, right?  You've at least had a friend who had one, surely.  No?  Maybe it's you!

I can't say I know exactly what causes these nurses to not only sign up to take lower pay and longer hours just so they can emotionally and verbally abuse nursing students but I will say that I have found one common denominator in each of these malcontents' story lines:  it happened to them first.

At some point during their fragile beginnings as a student or grad nurse, some other bigoted meathead decided it was their personal responsibility to break down every shred of confidence that this impressionable rookie had and pounded the remains into an effigy to the power of unhealthy fear.

So now it's their turn.

They've decided that the pain and anger has simmered long enough and it's time it manifested itself in the continuation of a cycle as old as humanity itself.

Why?

I have a theory:  Fear.

If someone is a one-way street  and their M.O. in every situation (good or bad) is to assign blame responsibility for the negative consequences that occurred or could have occurred (these people have no concept of positive outcomes) then you are witnessing a truly pitiful human being.  I mean this in the truest sense of the root word pity.  This person is living in their own hell brought on by who knows what events have befallen them.  The fact that they are perpetuating the cycle is simply them taking the easy road of dealing with their inner angst. The opposite of this is, in my opinion, is love.

I posted this video a while back to my twitter feed (@nurseofdoom) because I believe it touches on a couple fundamental points that I truly agree with; the most eye-opening one for me being that she defines blame as "a way to discharge pain and discomfort".  As I mentioned before, this is simply one of the manifestations of the fear this person is living in.  The video has a lot of other great points regarding how we all live our lives and how we make choices but I'll leave that to you.

So, you've heard this before?

Good.

But please don't just listen.

Change it.

Stop it when you see it because this cycle ends in only two ways: when people start acting out of love and the other way.

I know that my current situation is not dire and I am lucky to be well-equipped enough to deal with these individuals but the actions of bullying are a common enemy we must all share and work to end.

That, and a "used" VRE test may just find it's way into the instructor's lunch bag...

Reflect This...

"This is not a reflection, please redo and resubmit."

This is the verbatim feedback I received on one of my required but not graded 'personal reflection' assignments this past semester.  I found this to be amusing because these assignments are sold as a way that the student has a "written conversation (with their instructor) about clinical nursing practice."

I took this description to mean that just about any topic was fair game as long as it related to my clinical practice and i related how it made me feel.  Nope.

I wrote a one page reflection regarding my feelings towards the reflective process as administered by the University of Manitoba Faculty of Nursing.  Basically, they regard the reflective process as a tool with which the instructor can better evaluate the student's growth.  So far, I don't disagree.  Then the syllabus goes on to say that successful completion of the course is only possible when a minimum of three reflective journals have been completed by the student.  

Hold it right there.  

I don't know if it's obvious to the readers of this blog, but other than venting once or twice a semester, my reflective juices aren't sloshing about in sufficient quantities to slam out three journals in two and a half months.  Also, my personality isn't the type that often has a lot to say about my own practice and I'm sure my ACTUAL reflection wouldn't exactly pass muster with the instructor. For example:

"I really shat the bed when trying to insert an IV into my obese 31 year-old patient.  I should get better at sticking needles into fat, puffy things.  Perhaps voodoo?"

or,

"I didn't give my patient's acetaminophen in the appropriate time because I did not see that someone had changed the administration schedule in the MAR (medication administration record). By golly, I will just do better at looking at the page."

Yeah, not exactly what they are looking for I think. 

So, I had a thought that I would reflect on the reflection process itself as it was the only thing giving me any sort of emotional reaction that I could talk about at length.  So I did.  I poured out my heart (honestly, I did, there were even tear stains on the keyboard!) and I wrote a true reflection of my feelings toward my professional practice.

So, what hope is there for someone in my position?  

None, as it turns out.  

"This is not a reflection." 

So, what did I do?

I resubmitted a regurgitated version of how I really didn't like how the doctor was speaking to my patient about the root cause of her hypertension (starts with a 'Mc' and ends with a 'DELICIOUS!!!') and how I should always stand up for my patient and advocate for their right to clog their own damn arteries and I don't care how many hard-luck fatties the doctor has already seen that day he still better be sweet and loving to my patient!!!  

I get the journal back the next week.

"Very well done."

*facepalm*

I Suck

So I've attained a new record in the course of my nursing degree and I'm not proud of it. A 'C'... Hardly cause to push the panic button but cause enough for me to question each of my academic (and non-academic) behaviours.

I find that I often lose interest in the average lecture and begin amusing myself or daydreaming usually within the first 20-30 minutes. I find this to be an improvement over my previous record of not going to class at all. There is still adequate course time left to atone for this mistake but hopefully I can do away with the blood sacrifice to Florence...

Third Time's A Charm

Well, the nursing faculty obviously hasn't learned and have elected to allow me back for a third year.  I must say that I feel much different going into this year than I have in the previous two.  I feel much less contempt for my surroundings and have actually begun to appreciate a few individuals in my cohort.  So far, I've attributed this change to the fact that I've started drinking coffee in the morning but but we'll pretend it's progress or maturity or something of that sort.

In all seriousness, I don't honestly believe I will ever forgive myself for deciding to become a nurse.  The world of paramedicine will always be infinitely more intriguing to me and I don't believe I will ever match the satisfaction I experienced as a result of having worked in that vocation.  I will undoubtedly carry a measure of self-loathing with me as I submit to the perplexing and often convoluted nursing training and, ultimately, become 'one of them'.

I suppose this blog, being the outlet for all my negativity, serves as a sort of timeline of my progression through the transition from confident EMS professional to furtive, backstabbing RN.

Wow, three years of this and I still don't make any sense...

Retarded

What do you think when you read that word? When you hear that word?  Do you immediately think of someone in particular or a group of people in particular?  Do you immediately scrutinize the person who said it and in what context they used the word?  Or, do you skip straight to judgment as this word is a strict no-fly zone and any usage, regardless of context or intent, is cause for immediate hostile rebuttal?

I'm finding more and more that people in the general public belong to the latter grouping and their reasoning is simple, clear, and beyond reproach: "They can't help it."

These are the exact words quoted to me today by an individual who has precious little in the way of life experience and perspective but has a wealth of personal opinion based on nothing more than his own life (what more do you need, really?)

I had made the 'verbal faux' pas while referring to the fact that this imbecile individual had spoken to me in a manner that is altogether unbecoming and undeserving of any human.  This person was quick to correct me and mention that I, "Shouldn't use that word because those people can't help it.

This has got me wondering, do I use this word flippantly?  I am well aware of the derogatory connotations associated with the word and am fairly certain I meant none of them in my usage (at this time or any other time).  When I used the word 'retarded' today, I was specifically referring to the fact that this person was treating me in a manner that suggested they thought that I was unable to comprehend their normal speech and that i had taken offense to their subsequent condescension.

I loathe avoiding controversy simply because everyone else does and I really don't believe I am using this word in a derogatory manner.  Perhaps I am in need of enlightenment. Perhaps I need to use another word; but, in any case, there exists the fact that people exist who are of lower intelligence and mental capacity than others just the same as there exist people who are of different ethnicities.  These characteristics are apparent and they are not inherently wrong.

I am thinking in circles now.  I can only say that I don't believe it is wrong to point out a distinction but it does become 'wrong' when you intend that distinction to suggest their inferiority/your superiority.

Any thoughts, moron?

And That Was Almost Two...

I'm on a freaking roll here, next time you probably won't hear from me for four months!

Seriously though, I have to adapt to technology and hopefully the result benefits you as the reader.  Which is why I have decided to incorporate Twitter into my methods of sharing my thoughts with all of you.  You see, during the day at the university or while on clinical rotations, I sometimes have that one great thought and I think to myself, "Wow, I should write this down so I don't forget to blog about it later."  Then I promptly forget and end up racking my brain hours later whilst in front of my computer trying to remember the thought that was so great.  Other times, I think of things or hear things that make me giggle (that's right, sometimes it's outright chortling) throughout my day and it would be much easier to smack out a short note rather than attempt to stretch it into a full out blog post.

Enough about that, you can follow me, @nurseofdoom, on Twitter!

http://twitter.com/nurseofdoom