Beginning to feel the panic…

Clinical rotations start in a month for the FNP program I am attending. One thing I thought was a plus for the university I attend is that they assist with clinical placement, and have agreements with places all over the state. I knew it was going to be a hard road, so I started this process with emails to the coordinator February 1st. Emails go unanswered, and so, not wanting to be a pest, I waited until April 1st to call and get an update. NOTHING HAD BEEN DONE. I saw red.

And now I am stuck between a rock and a hard place. Because it’s less that a month before the start of clinical, and I dont have placement and the panic is driving me to distraction. I should be studying for finals…

I gave the coordinator 4 places to start, and another 4 places this past Monday. I am also making phone calls to various practices including local health departments and college health centers. I even joined my local chapter of the council of NPs hoping to network, but as luck would have it, the meeting scheduled for this week was cancelled. No one is willing to precept a NP student. I get it. It’s expensive and time consuming, and unlike precepting med students, there is no government money to help offset the cost to providers.

I’m frustrated. I am also scared because I dont know what the ramifications are if I am not placed. It’s demoralizing to be shot down over and over, and so that is affecting me as well.

Keep your fingers crossed for me, folks. I appreciate it.

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So my kid wants to be a nurse

And I really couldn’t be more proud. She has developed into quite a remarkable young woman, with a number of achievements already under her belt: she will be earning her Associates degree in liberal arts along with her high school degree, she has won her local regional science fair for her work on tarantula behavior and molting (and will be attending the international portion of the fair), and she has been accepted into all the BSN programs that she has applied to for this coming Fall semester, including one especially highly regarded in the country. It’s been her dream to attend this university since she was in grade school, and her father and I desperately want to make it happen for her, but financially, it would mean incurring a lot of debt.

There is a school, several hours away, in a major metropolitan area, that has offered her free tuition, and we would need to only cover room and board. We went to visit that school yesterday, and while they have a wonderful new facility for their nursing majors, my daughter isn’t thrilled with the school. It is a women’s college, it is small, and has a religious affiliation. Knowing my daughter, I realize she wont be happy spending 4 years of her life there. And despite her academic achievements, it is the only school that offered her a significant scholarship to attend. She has applied for many other scholarships, but they do not announce the awards until after we need to commit to a university.

This is hard. We’ve hit some major financial obstacles recently, and if it weren’t for those, our deposit would have already been made to “Dream School U.” She is being level headed about it, and realizing that incurring a huge amount of debt for her first degree isn’t the most fiscally responsible thing to do. But have you ever wanted to give something to your child so bad that it makes you ache inside?

She is going to be a phenomenal nurse. She comes home with stories from her volunteering time at the local ED, describing how she wants to jump into the fray and help the nurses, and she has already so much in the way of basic protocol for things like a patient presenting with chest pain. Of course, my bestie from nursing school works in that ED, and has helped nurture that in my daughter.

And this week, as we explored the nursing programs, and she toured the sim labs, she never hesitated to jump right in and become involved in any way the tour guides allowed. I am seriously, seriously, proud. I really cant wait to see where her nursing career takes her, because she is clearly going to make an impact in people’s lives.

How will we make this decision? Do we go for practicality for 4 years, despite me knowing she will not be happy at “Paid For U?” Or do we throw caution to the wind, let her get her education at “Dream School U,” let the debt mount, and hope for a future that allows us to help her pay down her debt?

Step away from the podium

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If you can’t communicate well, you shouldn’t be teaching. If you can’t compose a sentence clearly, you shouldn’t be teaching. If you grow frustrated when students ask questions, you shouldnt be teaching.

I am currently enrolled full time in an MSN FNP program. That means I am taking 4 classes. Two of those classes are being run by DNPs who have failed to learn how to communicate effectively. It is creating a special kind of hell for me, and with 10 more weeks to go, I am getting fed up of playing guessing games with my professors, wondering what their expectations are for each assignment.

Rubric? What rubric? Syllabus? The syllabus for both of these classes is an absolute joke. There is nothing specific about due dates, and it will elude to things like “group projects” but that’s it – no description, no due date…

It amazes me that people at their level of education have zero communication skills. Zero. In nursing, being able to communicate with others is of tantamount importance, and yet, these folks cant even explain their assignments clearly. Each assignment generates an entire class full of questions, and each answer only further muddies the waters. How does that happen?

Oh. And you dont get to be cranky about answering said questions. Be clear in your expectations, and maybe you wont be bombarded with emails asking for clarification. And when your clarifications require clarifications? Yeah. THAT is a problem.

I am paying big bucks to attend school. I am not taking out any loans, so instead we are tightening out belts and going without to make the financial commitment work. I want the most for my money, and this, quite frankly, is a disappointing return on my investment.

I feel angry and powerless to do anything about it. I feel like I have to keep my head low and plow through. But this is painful. And stressful. And I frequently find myself wasting my most valuable resource – time- because what I *think* the assignment is and what it *actually* is are two different things, only to become evident after I already spent hours on said assignment.

I’m going to have a glass of wine.

Diet Changes

Since I left the hospital, I have not only started graduate coursework, but also have worked to get a handle on the remaining obstacles to good health. My weight became a real impediment to my job and my daily functioning, and between Lyme Disease, nursing school, and night shift, I put on a record amount of weight.

A friend told me about the Ketogenic diet, a high fat, moderate protein, and low carb diet, that is meant to control the hormones that direct weight gain and weight loss. During that time, I have become a huge fan of Dr. Jason Fung, a nephrologist out of Toronto, who treats his diabetic patients with this eating plan, along with fasting. He has two books that I highly recommend if you’re curious: The Obesity Code and The Complete Guide to Fasting. That said, he has plenty of free videos on Youtube that are incredibly educational, and completely intuitive. He doesn’t talk above the listener or below them, and I like his delivery style.

About 3 months in, not only was I losing weight steadily, I was noticing that my hunger had really bottomed out. The next logical thing to do was to include fasting. I had already been intermittent fasting on a 16/8 schedule at the suggestion of my Lyme doc, so I moved on to a 36 hour fast once weekly, and then progressed to the alternate day fasting when I had some experience under my belt.

At first, it was easy. And I was dropping a good deal of weight. But it didnt remain easy. My second semester of grad school started, and the alternate day fasting was beginning to take it’s toll. I was hungry and tired on fasting days, and I was unable to focus on my homework. So I decided to switch to a 5:2 fasting plan, where you fast for 2 nonconsecutive days in a week. This plan has been in place for the past two weeks, and I am struggling with it. I was unable to get as much homework as I wanted to today because I was unable to focus, and I am tired, hungry, and cold.

I think it’s time to return to basics. Time to go back to just intermittent fasting, either on a 16/8 schedule or an 18/6 eating window. Time to tighten up my food choices, and pay attention to those sneaky carbs. I need to remind myself that this isn’t a race, the weight will come off, and that it will take some time to undo the metabolic damage my body suffers from. This is a permanent change for me, and I need to do the things that will bring me success in the long run. And if that means adapting my fasting to a more reasonable approach, then that is what it means. I still need to be able to focus on school, and my other family obligations.

In the end, I will still meet my goals.

In case anyone is curious about ketogenics, here is a link  to an article in JAMA.

Things that bring me comfort

A warm cup of tea.

A hot, lavender scented bath.

My sweet, feline companion.

Talking with a friend.

Reruns of my favorite sitcoms.

Browsing in a book store.

Journaling.

Currently, I am finding myself dragged into the chaos that is my extended family, and I wanted to take a moment and remind myself of things that I can turn to that will help calm the storm, quiet the frustration, and help me to return to a more productive state of mind.

Classes are open, and my phone has been lit up from group texts from classmates, as we all try to get started on the right foot. I’m too distracted and frustrated to focus, so I need to mindfully do something that will at least quiet my mind enough to get myself organized so that tomorrow will be a more productive day.

The syllabus for each class needs to be printed, and I need to go through each and write down important due dates in my planner. Last semester, my planner was a huge part of my success, as each week was laid out with all my tasks, and if I got them completed early, I was able to socialize a bit more, or take some time to work ahead. If I can accomplish at least that much, then tomorrow I can begin taking each class individually and focus on the work due this week.

This past winter break, I made great strides in clearing out room for extra textbooks, discarding unnecessary paperwork, and clearing off my work space so that I can be most efficient in my studies. My study is a place I like to come to. It’s *my* space, with a big, cushy club chair in the corner, and my books neatly arranged on a new shelf, rather than my desk, giving me a little extra work space.

So tonight, I will have my tea, watch some reruns of Frasier, and go from there.

 

Distracted…

 

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Second semester technically begins tomorrow, although we’ve had 2 of our classes open early, and yesterday I was beginning to work on my pharmacology class. Based on my nursing school experience, I am thinking this will be one helluva class, and likely demand a great deal of time. Rightfully so, too. I will be prescribing medications to patients, and it’s important to know what the hell I am doing.

My intention for today was to start on my other classes, which opened up this morning, apparently. My phone was blowing up with text messages from my classmates, making sure everyone knew there was stuff to do. But I was thoroughly distracted, because I received an email this morning from the doctor who put me down this path back in 2014.

The journal entry regarding the first steps down that path begins here.

I wrote Doc C last semester, because I wanted to ask if she would be interested in having me work with her as an NP student once clinical rotations began this coming summer. It takes time to do the paperwork, so I wanted to get a head start on it. But I hadn’t heard from her. I thought she either couldn’t financially swing the cost of educating an NP student (unlike med students, the government doesn’t compensate preceptors for an NP education, which causes the preceptor’s practice to absorb the costs), or worse, she wasn’t interested in working with me anymore.

Yeah, I can be a little catastrophic in my thinking at times.

But this morning, months after I sent her that email, she responds. And I have been edgy and floaty and basically internally squealing like some preteen fan girl. She has asked me to join her THIS SPRING, and although she is moving her practice in a different direction, she would still like to eventually send Lyme patients to me wherever I choose to take my practice. And by the way, “how do you feel about functional medicine?”

So, I am still composing my response to her, because I want to come across as level headed, and thoughtful, and basically not a squealing fan girl. I want her to know I would love to work with her, but I am not sure what my role would be considering I am only 1 semester into my education, and that even if I dont get credit hours for this Spring, I would still love to shadow her, at the very least. Perhaps we could experiment with my role in her practice, so that by summer, when I can get credit hours, we have a clear direction for what my duties can be in her office.

I still consider her absolutely brilliant as a physician, and I know I can learn so much from her. She is a rare find, that doctor. She has the mind and training of a physician, but the heart and bedside manner of a nurse.

 

Bah Humbug

I’ve grown to hate this time of year. It’s always incredibly stressful for me, and it usually starts in mid November and doesnt end until after New Years. Since I moved to the same town as my mother, into a nice sized home with some space to entertain, I’ve been expected to host all the holiday meals. And in years past, it wasn’t so bad. Everyone would help cook a couple of dishes, and so it was a manageable duty. But this year, I was already responsible for the entiree Thanksgiving meal, and now I am in charge of the entire Christmas meal as well.

Last year, I got a “break” of sorts. I was working at the hospital and I was night shift, so I was in no position to host anything. Would you believe both holidays went ignored because I wasn’t handling it? Yup. No one cooked anything or went anywhere.

This tells me something. The holidays are only important enough to celebrate if they are not in charge of it all. I feel taken advantage of and as if it is now expected of me, regardless of how I feel about it. So what have I been googling tonight? “How to avoid hosting the holidays.” I refuse to do it next year. I will be in my 4th semester of grad school, and intend to use it as an excuse. Someone else can step up, or not. I dont care.

And to make matters worse, my husband decides tonight, Christmas Eve, to invite a friend and his girlfriend over for dinner tomorrow. I abhor these people. Especially the girlfriend. And I will tell you why. Two Christmases ago, they came for dessert and coffee. I have a cat who gets very anxious around company and typically hides. But she also used to being fed at night (so we can sleep peacefully until morning without cries of hunger), and so she came out of hiding to eat. “Girlfriend” wanted to love on my kitty, but my angel wasn’t having any of it, and warned her with a few growls that she didnt appreciate being cornered. I told the girlfriend to be careful, she doesnt like strangers and she doesn’t like being touched. But did she listen? No. So my angel swiped at her. And what did “girlfriend” do? She lashed out at the cat with her foot, motioning to kick her.

And THAT is how she came to be on my shit list. So I am dealing with a husband who doesnt understand why I hate these people so much, and why I dont want them in my house for extended periods of time. Plus I have my own ungrateful family I have to feed and quite frankly, I am over all of it.

If anyone can come up with a practical solution to get me out of hosting the holidays permanently, I’d be forever grateful. I cant use the school excuse forever.