from the RN's desk

new york is a fascinating city. in my 5 days there, i was torn between fondness and animosity. i think i could love it if i spent more time there, but in the short term, i was shocked at the volumes of people that were everywhere. masses of them, always in the way. but the things i did and saw were wonderful. we did some really excellent bus tours and a cruise around manhattan and i got to see almost all of the boroughs and get a feel for the whole thing. i saw the statue of liberty and ellis island from afar, and we went to ground zero. what people have told me is correct: there's literally nothing there, it's just construction now. but the memorial leveled me. my mom and i split up as we walked through and when we met up again, we were both in tears. being right there made it seem so real and recent, even though it was nearly 9 years ago. i felt a fierce pride for my country as i looked on the plans to rebuild. it's undeniable that doubling the number of towers, some of them just as tall as the old, is meant to be a loud "f*** you" to the terrorists. the victims, their families, and the survivors deserve the beautiful memorial that is coming.

yep, ANGELA LANSBURY.

we saw 3 broadway shows in new york: jersey boys, billy elliot, and next to normal. we were torn, wanting to see a little night music and fences also, but time constrained us. i'm so glad it worked out that way, though. because of the mixed reviews of a little night music, i kind of wanted to see the stars more than the show. and i got to see angela lansbury up close and personal on the evening of her very last performance outside the theater!

jersey boys was glorious to listen to as well as watch. the four voices were absolutely perfect, and their harmonies were just gorgeous. i was also really impressed by the lighting. a very solid show that made me love the four seasons.

billy elliot was a spectacle even more breathtaking than i imagined. the little boy just KILLED it. it was pure magic to watch him dance. none of the singers really impressed me, but the chorus numbers were powerful, goosebump-inducing. the staging was really creative and every moment was visually entertaining. incredibly heartwarming, overall.

next to normal, however, was what made the entire trip for me. i was not anticipating the effects it would have on me. i love to cry watching a good show, but this was not pleasant, warm fuzzy crying. at one point, i was choking back sobs. really on the brink of losing it. i think the power of the show was how it touched people in different ways. it was scary how often i related to each of the characters, even though their circumstances are beyond what i've ever experienced. at intermission, i looked around me and every woman i could see was teary, if not as close to losing it as me, with her significant other holding onto her for dear life, terrified. i'm glad i didn't know the story or music before seeing it, because the twist in the first act was so devastating, and i know it wouldn't have been if i'd known. so...if you think you'll ever go see the show, don't read up on it ahead of time!

the music was astoundingly beautiful with lyrics that pierce the soul. reminds me a lot of jason robert brown, which is a very good thing. i'm listening to the soundtrack as we speak, which is excellent in that it makes me feel diluted memories of what i felt as i watched, but i'm glad i saw the cast i did. brian d'arcy as dan is better than the original guy...he has such a huge, rich voice. the voices of the two children were perfect. jennifer damiano is only 19 and she sings like...i don't know, i would say an angel, but she's so much more of a real person. i loved alice ripley's performance, but i have to say her voice is the only thing i disliked about the show. it's so gritty and warbly that it seemed to go in and out of tune, especially compared to the perfection surrounding her. i was not a fan, but her acting did move me. it was one of her last songs that destroyed me.

oh, and...i'm a nurse now. i have a license and everything. finding out i passed my huge monstrous exam was thrilling, a really good thing to happen on my trip. and now i can rest easy for the next two and a half weeks before my job starts. well, rest easy and...acquire my kansas RN license, clean my house, mow my lawn, be a bridesmaid, babysit for a week straight, and get my house grad party ready.

And you know that it's just a sonata away,
And you play,
And you play.
And everything else goes away,
Everything else goes away.
Everything else goes away.

standing on the precipice

am i going to feel like an adult when i acquire my nursing license? stand up as a bridesmaid at the weddings of two of my best friends? have my college graduation party? or when i start orientation? get my first paycheck? maybe when i actually go to the floor and take on patients. when i switch from my parents' health insurance to my own?

obviously, the feeling has not yet sunk in. this could be any other summer between semesters of school. except for the huge things looming in my future, such as boards (june 15th) and the start of my nursing career (july 12th). but in the meantime, i'm doing pretty much everything i wanted to do: settle into my new house and new room. sleep a lot. read more Scripture. get to some daily Masses. work out a lot (pilates is already yielding satisfying results). see friends at an acceptable frequency (yesterday was a great example. got pedicures with brie, watched glee with annie and rizzy, played super smash brothers with phil). take advantage of my temporarily free netflix membership (finally nearing the finale of six feet under). do things for my parents that pay (clean house, mow the lawn).

actually, i barely have enough time to study. since graduating, i have road tripped to st. louis and houston, moved into the new house, moved my brother back home, acquired shoes for two weddings and a bridesmaid dress for one, reread 3/7 of the harry potter series, joined the Y, watched two seasons of the office, made a scrapbook, resumed cantoring at church, and done some excellent catching up with important people. i have things going on every weekend until i start work. the two most exciting things are going to new york for a graduation trip and going to jacksonville for kelsey's wedding, which are back to back weekends. new york is the day after boards, actually. talk about a vacation.

i love what i see when i look forward, but also when i look around me. life is nice.

I am the nurse!

my class of 34 nursing students became nurses tonight. it was a wonderful thing

hello, actual life.

ihaveajobihaveajobihaveajob.

!

i interviewed yesterday, and the hospital felt good as soon as i pulled into the parking lot. there were so many things about the unit that i wanted to be a part of. i cannot describe how great it feels to know they were impressed by me, that i did enough things right that i got the call 2 hours after the interview was finished. i am going to be a pediatric nurse in about 3 months...an actual career. the thing i've been learning about for 4 years is becoming a reality.

since the job doesn't start till the middle of july, i have 2 whole months after graduation to do diddly. that's like, all i can think about right now. i love the prospect of being bored. love the shit out of it, actually. i mean, i will have real things to do. such as study for boards. figure out how to get a kansas RN license after i acquire my missouri one. help my parents move into their new house. but right now, i'm ignoring my homework (including a midnight deadline for a care plan) and making a list of things i can do during my sweet freedom time:

• lay out/swim every day. run every morning. get myself some abs.
• netflix is a must. finish watching six feet under and house. start some new shows.
• get back into piano lessons.
• find a show to audition for.
• go to june weddings without having to request off work (this is huge).
• more daily Mass. more adoration.
• see friends WHENEVA I WANT. so many people will be back in town.
• sleeeeeeeeeeeeeeeeeeeeeeeeeeeeep.

my life is no longer a black hole after graduation. it's beginning.

A Letter to Hollywood: Nurses Are Not Handmaidens

Dear Hollywood,

We, the nurses of the world, have something to say to you. Nurses are not what you think. Nurses are independent, highly educated, and skilled healthcare experts who save lives every single day. We work hard and are dedicated to making differences in people's lives.

And we are really sick of going home after a 12-hour shift, turning on the television, and seeing ourselves depicted as brainless bimbos. This has been going on far too long, and it has to stop.

But it isn't just disrespect that comes through in Hollywood portrayals -- it's contempt, and it's not at all subtle. You scorn us in the way you pigeonhole nurses on the small screen -- it seems that we're either half-wits, nymphomaniacs, or latter-day Nurse Ratcheds. Obviously, you have no concept of nurses as autonomous, knowledgeable professionals. We work alongside physicians, but we are their colleagues, not their subordinates. Yet in every hospital drama, physician characters are ordering nurses around, treating them like uneducated servants, or performing nursing care themselves and getting the credit for it, while the nurse characters just fade from view.

I can almost hear your reaction to my complaints. There, there, dear, don't take it personally, it's harmless, it's funny. Is it, really? Will it still be harmless or funny one day in the future when you are in the hospital and you press your nurse-call button and no one responds? Or it is answered -- eventually -- by a minimally trained hospital "technician"? The nursing shortage will have reduced our ranks considerably, and driven many of us into early retirement. It doesn't help the situation when schoolchildren and teens already discount the notion of becoming nurses because of the way nurses are portrayed on Grey's Anatomy. Becoming a nurse, they believe, is a waste of their talents.[1]

Maybe You're Misinformed

I'm going to give those in Hollywood the benefit of the doubt, and assume that they just have the wrong impression of nurses, and have no idea what nurses really do. But for the non-nurse readers, we'll pretend that you are in the hospital, and you've just had emergency heart surgery.

Who do you suppose will be at your side, watching your blood pressure, making sure you don't go into shock?

Who will be alert for the slightest hint of life-threatening hemorrhage?

Who will respond in mere seconds if your heart begins to beat irregularly?

Who will make sure that your chest tube doesn't get blocked and cause you to go into cardiac arrest?

Who will keep the circulation moving in your lower legs so you a clot doesn't develop and you don't die from a pulmonary embolism?

Who will be constantly watching to make sure that you don't stop breathing, that you are getting enough oxygen, that postoperative pneumonia is not developing?

Who will relieve your pain before you even have to ask?

Who will explain everything that is happening to you and teach you how to take care of yourself after you go home?

I'll give you a hint -- it's not your physician. It is your nurses. They will see you safely through one of the most dangerous times of your life, doing all these things and more.

And just so we're clear, I'll tell you what your nurses won't be doing. They won't be clustered around the nurses' station as though at a cocktail party, flirting with physicians. They won't be in the broom closet or the stairwell or behind the patient's curtain giving sexual favors. They won't be trailing after the physician as he marches down the hall, in case he needs a cup of coffee or someone to dump on. Nor will they be in the receptionist's chair, moaning about not being able to get into medical school. If these scenes sound a little familiar -- I'm not surprised. This is how nurses are regularly portrayed on television dramas.

Myths About Nurses Perpetuated by Hollywood and Other Uninformed Media

1. Physicians are nurses' superiors in the hospital hierarchy- nurses "work for" physicians.

Not true. Nursing is a separate, autonomous profession. We work with, not for physicians. We have our own leaders, and we regulate, license, and manage ourselves. Nurses decide what nurses do, not physicians.

2. Nursing doesn't require much education.

Nursing education is highly specialized, intense, and rigorous, because nursing itself is a profession grounded in science. Many people, if they believe nurses go to college at all, think that most nurses attend a brief 1- or 2-year program. In fact, 58% of nurses presently have a bachelor's degree or higher, a number that is growing every year. The "2year" nursing program doesn't really exist - the associate's degree in nursing requires prerequisites even before entering the nursing program, making it essentially a 3-year program. And in many areas, new graduate nurses undergo extended fellowships in the clinical setting that greatly increase their education and skill in nursing as they enter the profession.

3. Nurses mainly "fetch things" for physicians.

Nursing is a practice that is unique and distinct from medicine. Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.[2] Nursing's focus, and what sets it apart from medicine, is the whole person, not just the specific, presenting health problem, and nursing encompasses both actual and potential health problems. Nursing's scope of practice has been shown in numerous studies to save lives and improve health outcomes.

4. Nurses are those who aren't smart enough to get into medical school.

This might be the most irritating myth of all. It presupposes that nursing is just a tiny subset of medicine, a fallback for people who can't quite make it up the ladder. However, nursing is a different profession, not the same profession watered or dumbed down. Many nurses go on to earn advanced degrees at the master's or doctoral level, but they are still practicing nursing (note that nurse practitioners and other advanced practice nurses may share some of the same functions as physicians in their specialties, but they are philosophically nursing-oriented in their approach to patients). And research shows that care provided by these advanced practice nurses is equal to or better than that provided by physicians.[3-6]

Laura A. Stokowski, RN, MS

1. Inglis M. Put off nursing by TV portrayal. Evening Telegraph (UK), December 18, 2009

2. American Nurses Association.Definition of Nursing. Available at: http://www.nursingworld.org/FunctionalMenuCategories/FAQs.aspx#def Accessed February 3, 2010.

3. Laurant M, Reeves D, Hermens R, Braspenning J, Grol R, Sibbald B. Substitution of doctors by nurses in primary care. Cochrane Database Syst Rev. 2005;18:CD001271.

4. Dierick-van Daele AT, Metsemakers JF, Derckx EW, Spreeuwenberg C, Vrijhoef HJ. Nurse practitioners substituting for general practitioners: randomized controlled trial. J Adv Nurs. 2009;65:391-401.

5. Lenz ER, Mundinger MO, Kane RL, Hopkins SC, Lin SX. Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Med Care Res Rev. 2004;61:332-351.

6. Aigner MJ, Drew S, Phipps J. A comparative study of nursing home resident outcomes between care provided by nurse practitioners/physicians versus physicians only. J Am Med Dir Assoc. 2004;5:16-23.

spring break highlights

Things I love(d) about spring break:
(Phoenix, AZ and Destin, FL)

1. The babies.
2. The family game of Fictionary that was funny enough to make me inhale my beer (literally) and my mom spit hers out as if from a blowhole.
3. Sunshine.
4. Uncle Dan: “How’s that necrophilia thing going, Jamie?”
   Jamie: “It’s narcolepsy.”
   Uncle Dan: “Whatever.”
5. “I take pills, so I can sleep with anyone.” -- my grandma
6. Being a part of my newest cousin and godson being baptized into God’s family!

1. 7. “Gimme that filet of fish!”
   8. Making “bro” into as many words as possible—broverload, Bad Bromance, etc. Florida, especially Panama City, is just ridiculously full of bros.
   9. Getting hit on by a drunk girl coming out of Spinnaker’s in Panama.
   10. The beach. And our private, gated access.
   11. Getting the shit kicked out of us by red flag waves.
   12. Wearing flip-flops and shorts.
   13. Everyone (including my 3 super athletic friends) being absolutely terrible at tennis.
   14. Hearing the same 10 songs on repeat on the radio. So. Much. Gaga.
   15. Staying in a resort where the average age of all the other residents was 65.
   16. The best seafood/sushi/Japanese food buffet in the world for $8.99.
   17. The fact that storms were forecasted every day and it only rained at night.
   18. The tiny alligators at Fudpucker's and the weird ass albino one.
   19. The club that was actually worth a 2-hour wait.
   20. Sharing a studio with 3 other people for nearly a week and no one getting killed.

intracontinental

I think I made up my title word. It should have something to do with traveling across the continent, but in my head it also reads as something medical-related. A problem specific to geriatric bowels. Teehee.

Reading David Sedaris makes me want to be a writer. This happens to me when I enjoy some type of art form. I see a show and want to act, I hear an opera and want to be a singer. Everyone does that, right? I am on a plane, squished between seats “C” and “E,” completely unable to sleep. Weird for me, I know. I think I just feel like I need to be doing something. That’s what Truman does to us. We’re so conditioned to having more on our plates than we can possibly accomplish that once we do get a break, we don’t like having idle hands.

After two really stressful weeks at school that made me want to stab myself in the eye, I was rewarded by a couple successes yesterday. A fun coincidence was how much Matt rocked at life yesterday, too...he was named Justice Systems Student of the Year and got a 100% on an exam. I like dating a fellow nerd so we can brag about this stuff to each other. My senior nursing exit exam was scheduled from 8 am to 1 pm (yeah, disgusting). It was a national, standardized test designed to predict success on our RN licensure boards (or NCLEX) that we will take following graduation. I scored really well and I'm now in a very good place for passing boards. And it took only 2 hours, which made my day. I didn’t think I cared about this exam. It’s not for a grade and if I didn’t do well, I’d have plenty of time to study and improve my test-taking strategies. But NCLEX-style questions have been my nemesis since sophomore year. NCLEX logic is a wily, unforgiving bitch that rarely allows me to win. It was ridiculously satisfying to destroy her and then be finished with school for the week.

Yesterday I also found out that I was cast in a one act…Sovereignty, directed by Kyle J. Smith. Kyle let me read his script earlier in the semester when I didn’t think I’d be able to audition (embarrassingly, I was counting on being cast in the mainstage musical a little more than I realized) and loved it. I won’t ruin it for anyone, but it’s very different and powerful. It’s going to be really challenging for me as an actor but I think I’m going to learn a lot about movement and being physically comfortable on stage, something I’ve always wanted/needed to do. I was flattered to be cast because he has a really interesting, creative vision as a director that I respect. But mostly, I’m glad that my last theatre experience of college (maybe the last ever) will be filled with poop jokes and Harry Potter references.

I can safely say everything rocks right now. I’m on my way to Phoenix for my godson Elijah (Eli)’s baptism. I was so excited and honored to be chosen as his godmother because his parents are some of the coolest, holiest people I know. They’re amazing examples of what being Catholic means and I hope I can be something close for their son. And I can’t even say how ready I am to meet him! This weekend is going to be jam-packed with family goodness, and the sunny climate is quite a bonus. I’m traveling with my mom, my aunt Jean, and my grandma, and I can just sit back and be entertained by how those three interact for hours. Then on Monday instead of flying back to KC, I’m flying to Destin, Florida. My friends – Alex, Eric, and Mickey – are road-tripping it down tomorrow (which I’m a little sad to be missing but the baby fest is totally worth it) and we have a condo for the week. This will be four of the five group members that went on spring break last year and I have every reason to believe this trip will be as epic or more so. And then the week we get back from break I have my first job interview with the Intensive Care Nursery at Children’s Mercy in KC, where I have wanted to work for years. So I’ll have to make a quick turnaround from sunburned and hung over to nursing/business chic, but I think I’ve gotten good enough at switching hats.

I just realized that I capitalized correctly for the entire duration of this post. This is because it’s being composed in Word rather than online. For whatever reason, when I write in casual social networking types of mediums, my fingers avoid the shift key like the plague. But that feels inappropriate when I do word processing. Jamie, you are on spring break. This is not homework. Oh well. Truman student for life.