Destination 

Off to...

Great city of angels, the repository of divine gems, the great land unconquerable, the grand and prominent realm, the royal and delightful capital city full of nine noble gems, the highest royal dwelling and grand palace, the divine shelter and living place of reincarnated spirits. Otherwise known as Bangkok.

I thought I was leaving in a couple of days and just discovered a few hours ago that I'm going tomorrow. Good thing I checked. I've been scrambling around the last few days for those last-minute travel supplies and can't-live-withouts (like Cliff bars and film). I managed to scrunch everything into my pack. Funny how that thing gets filled to the brim no matter how much - or little - I pack.

I'm excited for the trip and not even dreading the long flight. Not too much, anyway. It looks like I'll have my choice of movies: Monster-In-Law, Kung Fu Hustle, Ice Princess, etc. I'm a little bummed that Tomb Raider wasn't on the list, since I thought I should check out the movie before going to Angkor Wat. C'est la vie. I'm sure I'll enjoy the temples even without the vision of Angelina Jolie swinging through them on vines or whatever she did. In fact, I'll probably even enjoy them more without that visual.

I made a hotel reservation, which is always a sketchy prospect when it's last minute and a world away. From the pictures, it looks okay. It's located "conveniently near Patpong," the big sex industry area so it should be a good introduction to Bangkok. There also seems to be a 7-11 across the street, at least, if I'm reading the map correctly, so I'll probably feel right at home.

Speaking of introductions, I've heard lots of stories from J about all of the street dogs running around and imagine my surprise to see that they have their own blog. You can check it out at http://bkkstreetdogs.blogspot.com/.

Oakland, part 2

Gertude Stein's take on Oakland: "there is no there there."

Oakland

I expected a reprieve from the smell of urine that permeated my clothes and respiratory system while at the VA hospital, but a business trip to Oakland has kept the dream alive. Now don't get too bent out of shape, I'm sure Oakland generally smells like roses but the hint of urine in the air turned into a literal stream when I rounded a corner and practically ran into someone relieving himself on the street. Going along with the rough-around-the-edges impression, I was awakened in the middle of the night by some booming bass. I finally called the front desk to complain and their response was "oh yes, we've already called the police." I made sure that the chain lock was on the door before going back to bed.

I'm here for a couple of days of meetings and things are going swimmingly. I was upgraded to first class going and coming. I did a little shopping in Berkeley. Had a nice dinner at a French restaurant. Ran into an old coworker while in line to sign out of the lab (random!). And head home tomorrow.

OVER

It's done. We took our last test today, finished our last 308 assignment, and completed the last evaluation. I can't even believe how quickly the summer's gone by or how much was crammed into my brain in the little time I've been in nursing school. Aside from the whole clinical thing, I think this quarter's been a pretty big success. I doubt that anyone flunked. We had some great (great) instructors. I have cool classmates. And I'm looking forward to the next quarter. Five weeks from now. Five glorious long weeks. Five weeks with no wake-up call, no clinical, no purple scrubs, no 8 hours of class with no break, no last minute assignments, no forgetting lunch, no having to buy coffee because having to spend an extra five minutes making it at home might very well be the thing that pushes me over the edge, etc. And after that five weeks, I'll be ready to continue traveling the road to becoming an RN.

The beach

After a whole lot of whining, wheedling, wheeling and dealing, I managed to get away from school for a few days to enjoy the K family reunion at Cannon Beach. It was so great to get away, see family, spend time with B, and read books for pleasure. The pharm final (tomorrow) was a big black cloud over my head while there, but I managed to squeeze in some studying between all of my eating and drinking and napping and reading and drinking and chatting, so I'll survive.

By far, the best part of the trip was a visit to the doggy shop where M got new duds for the beach. I was really pulling for him to get a puffy down vest, but he wound up with a shirt, windbreaker, and fleece instead. I was crying, literally crying in the store as we tried these things on him. I can't remember the last time I laughed so hard.

M's beach duds

Time with B . Typical - I'm trying to have some QT and she's watching pigeons.

Passing pills

I was on hook to pass meds today, which isn't terribly exciting but still better than having nothing to do or waiting for the evaluation with the instructor which also happened today.

I met my patient early in the morning, a nice old man with some dementia and other old man problems. While we chatted he was lying in bed, covered, and I took his vitals. I left to collect his med drawer and the instructor and by the time we got back he was sitting up and eating breakfast. He didn't have any pants on. No pants, no underwear and in fact, just the t-shirt on his back. I noticed pretty quickly, but he was sitting on his bed with the bedside table pulled over his lap, so he wasn't exactly on display. Still, I said "Hi Mr. F - we're here with your medications! Would you like a few minutes to get yourself together before we give them to you?" He said no, he was ready and so I looked at the instructor and she made a "go ahead" motion and I gave the guy his meds.

Once we got into the hall, the instructor grabbed me and said "just for future reference, you should never give a patient his meds when he doesn't have pants on. You should have covered him first." Hmm, there's something they don't put in the pharm textbook. I was glad to have learned the lesson, but it seemed like it was going a little too far later during my evaluation when the instructor used the passing-meds-with-no-pants incident as an example of my "lack of common sense." She also talked to me about my communication issues and hinted that I needed therapy. But I still got off lightly since she actually diagnosed another student with a mental disorder during their eval and recommended drugs.

P.S. I returned to my patient's room with a pair of hospital pants and then helped him find his jeans tucked under the mattress.

Health assessment

Final #3, consisting of 50 multiple choice questions about tonsils and cranial nerves and arteries and something called the Karnofsky assessment (I still have no idea what that is), is over. I didn't do a whole lot of studying over the weekend or last night, but it's a pass/fail course and I just plain old don't care anymore. Plus I was keeping up with the material pretty well. Anyhow, after the test, students can go look at the answer key and count up how many questions they got wrong. I did this for the midterm, but today? I just didn't care. It's over!

Head to toe

Final # 2 - the head to toe exam - is finished! I had to examine a classmate (from head to toe, natch) in front of a TA and get 'passed off' on the 72 skills it included. I managed to feel for the dorsal tibial pulse in the anterior tibial area...no pulse there...and palpated the PMI rather than actually observing it, but otherwise things went well and the TA gave me some good feedback and said I passed with "flying colors". Hurrah!

The VA

In what may have been my best clinical day to date, I changed exactly one bed, took one set of vitals, and one other patient's blood pressure. And yet I still managed to fill 8 hours. I've given up trying to learn anything from the clinical, which is probably a bad thing, but how many times do you have to make a bed/give a bed bath/take a blood pressure/walk in circles to say that you've mastered the skill? I was trying to think of anything cool that happened on our floor that I'd like to learn to do and drew a complete blank, so now I just need to make it through two more days without giving the instructor cause to fail me.

I did have the best patient today - he was the absolute highight of my quarter. He's the guy with the herpes lesions from last week (it was herpes zoster by the by) and was apparently feeling lots better since he was dressed and in a chair by the time I met him in the morning. We started chatting about his day and his research which currently involves watching movies to determine whether homosexuality is genetically determined or an individual choice. This wound into a discussion of the Momon religion's views on the subject, then on his own personal history wherein he just came out of the closet a couple of years ago after the death of his wife. After covering his kid's reactions to the event, I managed to take his vitals (one of the three things I did today), and then the conversation picked up at his literary studies in Chaucer. He quoted Middle English for me and described the language of Chaucer's time and then we discussed my own favorite author (Oscar Wilde, of couse) and the recent film about his life (OW's life, not the patient's). I left at that point to get some clean linens so that I could change his bed (thing of the day #2) and upon my return we reviewed the healing powers of nature, the color purple (not the book, but the actual color which happens to be a fave of both of ours), and educational theories of the day. When I interviewed him about his skin integrity he reported "honey, I'm in bliss rather than blisters" and on popping back in his room to ask if I could bug him with just one more question, he remarked "I don't wear women's clothes, if that's what you're going to ask".

It's well and good that I can have such a grand ol' time chumming with my patient, but it still seems like the clinical experience at "the Number One Nursing School in the Country" as we're constantly reminded should be a little more than Chaucer chit-chat. At least one of my classmates has remarked that she actually likes the clinical and enjoys the interaction with the patients, which makes me feel like a bit of a heel, since of course I've got no beef with the guys. But would it be asking too much to see an actual RN at work for a change?

The crunch

It's full system meltdown in my world these days. The end of the quarter, the finals, the stress of trying to get away for my upcoming family reunion, the dishes in the sink, the hot weather, the frustrating quizzes, the irrational clinical instructor and so on have pretty much shut down my brain. Yesterday I was certain that my brain was going to implode and/or turn into a mass of jelly that would slide down my spinal column and lodge in my coccyx.

I'm not the only person getting weird though. While I'm not so sure that's a good thing, at least I'm not the only person who's amused these day by things like the word "stopcock" coming out of my lab instructor's mouth. Classes yesterday ended with a strange conversation about providing perineal care (washing the genitals, in normal peoples parlance) to persons of the same or opposite sex. I admitted that I'm not so comfortable with the whole thing on men - light or soft touch? How do you deal with the sharpeis? What would hurt them? O turned to me afterwards and said that she also wasn't so sure, particularly with the erection mechanics. "Could he get an erection if he isn't thinking sexual thoughts? Like, could it happen unintentionally? And once he gets one, does that mean that he's horny?"

My mid-week brain break comes in the form of a standing date for pub trivia at a cool little English pub nearby. I'm not so hot with the trivia, but I can put away a beer like nobody's business, so I think it evens out. The last couple of weeks it's just been K and I at the pub, so we haven't played trivia so much as take pauses in our conversation from time to time to see if we know the answer to a question (we never do). But it's a great chance to catch up on K's dating adventures, which have really picked up since he started the quest online. He's getting out there and meeting lots of girls - I'm so proud! I'm also happy to live vicariously through his adventures since I don't seem to have a spare cell in my body for dating at the moment.

Not dating is probably a good thing at the moment. Every once in a while I find that my life has become a serial with an exposition and an arc and an overriding theme. This week starts off with condom catheters and rashy buttocks, then some not-so-innocent kissing by the lake, prosthetic penises, and finally frank talk about perineal care. I can't even begin to imagine what's going to happen next.

Room 691-A update

I leaned this afternoon that the patient in 691-A* has a prosthetic implanted in his penis. So not an erection after all.

Abstract book bag