24- personal end of semester update

On this palindrome Saturday I am going to be digressing from the Alice in Wonderland school series I have been writing and will be writing about myself and my program.

Why?

Because it is nearly the end of the Spring semester and it’s been a hot minute since I did an update.

Two weeks remain in the semester.

That is 2 more times driving to the university for my research assistant job. I did decline to work this summer for the department as I anticipate life is going to get very interesting and busy over the summer.

That is 2 more assignments. One in the qualitative research class and 1 in the measurement class.

As the qualitative, I should have seen the writing on the wall. I do not care for math. Especially the kind of math that is required for quantitative research. Statistics makes me itch a bit. You know? I am leaning into the qualitative sphere. And this is shocking to me.

Talking? To other people? Not really a strength of mine. But here we are.

For the third class, the directed research class, I was thrown off a bit by being sick for 2 months starting in February. I just feel like I got a slow start. But that’s okay. I am chipping away at it. Next week I will be presenting my directed research project, an observation project, to the corporate research council. After that, and after the blessing of the school IRB and the hospital IRB, I will dive into the observations and finish the class.

Thankfully, I am not the first person to have a slow start and there is a process for this.

For the rest of the summer, I will be preparing for and taking my preliminary exams. These are exams that separate the PhD student you from the PhD candidate you. These are also the threshold that must be crossed to begin dissertation work.

The exams are timed, kind of, and meant to be written over two weeks from home, or 3 days at the university. I will stay home, thank you, and write them from here.

After I pass the preliminary exams (I hope) I will start work in earnest on my dissertation project and my dissertation itself. As I understand I will need to have it completed and defended by March if I want to graduate in May. The directed research informs the dissertation project research.

I have had so much support from the university in this journey. And a journey it is. And support from family and friends.

I need a better answer to what are you going to do after graduation?

For the longest time, the answer has been write for publication. I might throw in some teaching in there too.

After the end of this semester, I will be a 3rd year PhD student. If you had told my younger self that I would someday be looking at and surviving a dissertation she would have laughed.

Oh, boy.

Let’s get started.

School Me Saturday 4/13/24- Goodbye, hello…I’m late, I’m late, I’m late

It happens to everyone.

And I mean EVERYONE. Including the White Rabbit from Alice in Wonderland. Well, it seems to happen to him a LOT.

An assignment slips your mind or, worse, doesn’t make it onto the calendar. The calendar of assignments that you live and breathe by.

What do you do?

This advice is compliments of my first ACLS teacher. The first thing you do is take your own pulse.

In this instance, taking your own pulse helps you to not panic.

I know wild things are going through your head.

This assignment is going to be late. I’m doomed.

This assignment is going to be SOOOO late. I’m gonna fail.

This assignment is going to be so late that I will have to wail in the afterlife with calendars shackled to my wrists. A la Morley in the Christmas Carol.

Yes, a little book mixing that you didn’t know was possible.

Take a deep breath.

It will be okay.

First things first, email your instructor.

They are people too and they know that life happens. Life definitely makes a habit of getting in the way of adult learning because you probably have a job and responsibilities. Maybe even children.

Now that you’ve emailed your instructor, read the assignment and make a plan to get it done.

Often points will be deducted because it was late. But it is late and this is the way to minimize the fallout. You could just not do the assignment. But then you won’t learn the Student Learning Objective that is often a building block to the next SLO.

Email your instructor and get to work on the assignment. Because points are points.

Do not panic.

School Me Saturday 4/6/24-Down the rabbit hole

Being in school very often results in having to do research. This can be for a paper, or a discussion post, or for a class. Students are always doing research. You trot on down to the library, at the college or other, and you, hopefully, engage in conversation with a research librarian.

These magical creatures exist to aid students. Kind of like the kindly shopkeeper or the stray magical beast who gives you the answer to your quest.

Except being in college is not an adventure game. I mean, it is, but not that kind.

Let’s pretend it is the middle of the night and the library is CLOSED!

And the assignment is due tomorrow!

What then?

For a student in this situation, there is probably an online version of the school library.

There is also Google Scholar. Warning, many of the literature hits from Google Scholar is open source. Which may mean they paid to get their article published. It is still a good option though, and better than plain Google.

But the clock is ticking and the assignment is getting hot. You enter your search terms in Google Scholar or the library, and this results in 4,332,662 hits. Far, far too many. This is where you start refining your search question and publication date. Often, schools only want literature or research from the last 5 years.

Through judicious refining, you only have 15 articles to read. You start reading the titles and find that they have little to do with your original search. But they are interesting and you keep reading.

And reading.

And finding.

And reading.

And finding.

Suddenly it is dawn and you can use absolutely none of the articles that you’ve found. You wanted to find articles about prohibition and suddenly you are reading about they made wine in 500 A.D.

This is the research rabbit hole.

You just keep digging yourself deeper in search of good stuff and all you are finding is not usable for this paper/assignment.

Research is a skill.

But even the research librarian has gone down the rabbit hole. Just ask them.

You are still going to go down rabbit holes. Being aware of the possibility of a fruitless search lets you make decisions about what to read and boundaries to put on your search.

Seriously though, reach out to the research librarian at the school. Or at the actual library in your town. They will have strategies to help.

What to do when the person you are on call with does not answer their phone

I get it. Sometimes you don’t hear the phone ring. Sometimes you are in such a deep sleep you don’t hear it again. When that happens, I try the alternate number. When there is no answer there I make alternative plans.

This happens to everyone. Even me, after the thousands of call shifts I’ve covered in my career. Once upon a time my phone and the pager malfunctioned at the SAME TIME! I am not sure of the odds of that but I bet they are astronomical.

I should have bought a lottery ticket.

My point is that it happens. It happens often enough that I’ve developed a task list on how to deal with it.

I could call management. And I have when it is warranted. But that doesn’t get the patient, who was sick enough for us to be called in during the night, on the OR table. Calling the manager at the moment delays care. They would do the same thing I’m going to tell you anyway.

Pull out the staff phone book. Every OR has one. This is where the pager numbers, phone numbers, and alternate numbers are stored.

Start down the list until you find someone able to come in.

Off cookies if you have to.

Eventually, someone will say yes. Sometimes it is after you’ve called all the scrub techs and no one is answering their phone or available.

It is important to note that after 5 no responses (about 2 minutes) you should call the manager. In case they have to come in. But of the tens of times I have had to find another person to come in, this has never happened.

Another alternative is to call the people you know can handle the role in the OR. Some nurses, myself included, can scrub.

It is also important to cultivate a list of contacts that probably won’t say no to you. Don’t tap that resource too often, or you will burn them out.

The next day have a friendly chat with your manager about the problems overnight.

There you have it. What to do if there is a case and the person on call is not answering their phone/page/alternate number.

Tuesday Top of Mind- March 19th Certified Nurse Day

I know I just wrote about how recognition can be cringey. Especially for an introvert.

However.

Touting your accomplishment is not cringe.

I’ve been a certified nurse operating room (CNOR) for 15 years now. I just renewed!

When you are in a specialized area such as the operating room, emergency room… heck, all hospital areas are specialized and all have their own certification.

But what does certification mean?

It means that the nurse

To me, it means that the nurse cares enough about the processes of their care and their patients, to study hard, find a certification test, often pay money out of their own pockets to take the certification test. Yes, it means an additional set of letters after your name, but all the certified nurses I know say it is not about that.

They speak to their dedication to the art and care of nursing and this has caused them to want to be certified. It is not about the money. It is about showing everyone that you are proud to be a nurse. It is also a declaration of what kind of nurse you want to be.

To the certified nurse, nursing is not about the paycheck, of putting the hours in and stamping that time clock, or working or not working that overtime. Or getting everything done so you can get off the floor, off the unit. It is about caring and wanting to see the best outcomes for your patients.

That is why I am and have continued to be a certified nurse.

School Me Saturday 2/3/24-first assignments of the semester

It is hard to go fully into the semester. I know. All the reading, all the getting to know the professor. All the getting to know the other students. It is hard.

Especially if you are not socially gifted.

Believe me, I know.

However, the first month of the spring semester should be just about over. This is about the time that the first assignments are due. This can be a variety of assignments, a paper, a discussion post, a test. School does it all.

The only thing I can tell you is to have a plan for the assignments. Make a schedule if you are gifted like that. Or, if you are like me and write a schedule only to ignore it, write down the assignments everywhere. As discussed, part of my process is largely mental and I do a lot of thinking about structuring assignments. I have heard over and over to use an outline for written assignments. Yesterday I did and I wrote down what each section of the paper was to cover, and the broad strokes of the beginning and conclusion. Where has that nugget of wisdom been all my life?

We’ll see how far that gets me in the next three months.

It wouldn’t be the start of the semester assignment season without technical difficulties.

You are not alone in this. My computer got replaced for the second time over winter break. All the software had to be re-installed. Including the specialized software for statistics.

Oh, boy!

Take a deep breath and make a plan to conquer your first assignments. The first one, I find, is often the hardest to get started. After all, students, like us, are coming off a break where we did little to nothing to prepare for school. It might take a minute to get our brains in gear.

Start your assignments! The checkered flag has been raised!

Yeah, that is a veiled attempt at a NASCAR joke.

Humor me.

Convention planning season, anyone?

If there is something a nursing organization loves it do, it is to plan a convention. I’m a member of the Association of periOperative Nurses (AORN), the North Carolina Nursing Association (NCNA), the Sigma Theta Tau (nursing honor society), a reciprocal member of the American Nurses Association (ANA) through AORN, and the association for nursing professional development (ANPD).

Every single one of these organizations, that I pay and get educational benefits from, has its own national or international convention.

There is only so much money to go to the conventions.

I am a lifetime member of AORN (can’t recommend this enough) this means I paid $950 one time about 10 years ago instead of $150-$200 per year with reimbursement from the hospital. That means I get the benefits of the ANA and AORN for free because I am a lifetime member of AORN. The dues for NCNA usually cost me about $150 because I have a student membership. The dues for Sigma Theta Tau are about $125. I won’t be re-upping ANPD because I don’t have enough time in my life.

I am presenting a poster at AORN and will be traveling to, staying at a hotel for several nights, and attending the conference. We are driving because it is close-ish, just the next state over. I already arranged for our hotel room. The travel and the accommodations will cost money but the conference itself will be $580 with early bird pricing, and $680 after February 1st. I am registered.

Through work, I can get reimbursement of $1,500 on educational opportunities. It isn’t gonna cut it. The $580 I spent on registration will be reimbursed. Leaving $920 to spend on the other organizations and the renewal of my CNOR, which is $380. And the NCNA dues will drop that down to less than $400. I am grateful that there is even that amount for reimbursement.

All the other conferences, I will not be in attendance.

Because I cannot afford to travel to all of the places the conferences are. For example, Sigma Theta Tau’s international conference will be in Singapore. The ANPD conference will be in Chicago. The Magnet conference with ANA will be in New Orleans. The NCNA conference I will consider because it is less than 20 miles away.

Going to conferences is expensive. But the education that you can garner from the conferences is very useful to the bedside nurse.

But the only conference I am planning on this year is the AORN.

Mentor and preceptor, explained

There’s a quiz going around on Facebook about who a new peri-op nurse would want in their life. A person who has clinical competence and experience and mimic them. Kind of a fake it until you make it.

The answers are preceptor, mentor, role model, or educator.

Let’s break those down.

A preceptor is the person who trains you in the policies and procedures of the hospital. They are the one whom the new peri-op nurse follows to gain knowledge about their new role in that particular hospital.

There has been a movement away from having unit educators anymore. I know in the hospital system I work for, the unit educator’s role has been centralized to a central office. This means that less of them can do the work that is necessary for annual education. However, this also means that the unit loses that person who is the dedicated educator for the unit. Our last educator left after having a baby and they centralized the education department. She was never replaced and the education got punted to the assistant nurse manager, and those of us in the unit who stepped up to serve in the educator role. Even if a unit had a dedicated educator they serve the entire unit and personalization of education goes to the wayside.

A role model is someone to look up to in the department. They could be good at their job and admired by staff and surgeons alike. They have clinical competence and experience. But this is a shallow relationship. A role model is sometimes imitated, but sometimes it is for a reason that is not in the patient’s or the department’s best interest. Especially if they are admired by cutting corners. Cutting corners is dangerous.

A mentor relationship is all of the other three and a deeper relationship. They are the one that the peri-op nurse goes to with questions, or reassurance. They are the ones that notice when someone is having a bad day, and invites them for a cup of coffee to talk about it. Mentors are important.

Luckily, I have a built in mentor in my mom, a still working nurse with 50 years of nursing experience who does all the things a good mentor does. She listens when I have concerns, she talks through solutions with me, and she will give me a mild correction when I need it.

This is what I think is the answer to the question. A mentor is all the things in one.

All new nurses need to find themselves a mentor. All nurses need to find themselves a mentor too.

School Me Saturday 1/6/23-the semester is coming

Break time is over and the semester is starting soon.

There are two ways of looking at the imminent start of the semester.

On one hand, there is excitement. Yay! The semester is beginning. This is the semester where I turn it around and get all my papers/studying done early so I won’t feel so stressed when the due date looms.

On the other hand, there is dread. Another semester? Didn’t we start break like a minute ago?

Or a combination of the two.

Me, I’m a combination of the two. Each semester is bringing me closer to the end of the PhD program! And each semester is bringing me closer to the dissertation!

Both things can be true at the same time.

Ultimately I think that the beginning of the semester is a chance to wipe away the previous one and begin anew. After all, we are learning how to create and build the project, do the project, and write up the project.

Of course, we won’t do it perfectly the first time.

This is where the mantras come in handy.

Right foot, left foot, the only way out is through.

As long as you do no harm, take no shit in the process.