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Wednesday, May 31, 2000

Nursing School - The LPN Year Part I

I didn't remember being this nervous on my first day of high school, and I was nervous then.  The night before I had carefully selected and laid out my clothes.  The concept of having to put together an outfit that wasn't a work uniform or holy jeans worn around the house with a t shirt had become foreign to me.  Being married in the middle of nowhere will do that to you.

My alarm went off early the next morning, but I was barely asleep anyway because my mind was racing with thoughts. I didn't know a single person who was going to be in my class.  We had an orientation months ago at the beginning of the summer, but I did not walk away from that with new friends or fondness for the upcoming school year.  In fact, I sat quietly in the front of the room as everyone around me joked and discussed their plans for the summer ahead. No one cared when I asked them questions and certainly no one asked me questions.  A feeling of awkwardness washed over me.  Would that be what my year ahead was like?  I hoped not. 

I reached the college early.  My classes were being held at the college I graduated from two years earlier with a Bachelors degree so I was well versed with everything on campus.  The classroom where I would spend my next ten months was right next to the mail room in the basement of a building that was built sometime in the early seventies.  Classes would be televised and viewed in three different locations across the state.  The teachers would rotate between the three sites so on some days we would have a teacher right in front of us and other days we would have to watch them at another location over the television and talk to them through cameras and microphones. 

When I walked into the class room I was surprised that most of my fellow classmates were already there.  Again, that feeling of awkwardness washed over me.  Where should I sit?  I didn't know anyone and, just like months ago at orientation, everyone was already having conversations amongst themselves. 

A seat in the back of the room looked inviting. The back row was empty so I plopped myself in the middle of it.  There is always safety in the back of the room, but eventually my sanctuary of an empty row received company.  A bubbly little girl we'll call "Macy" sat next to me.  She smiled and scootched close as she said how nervous she was.  We exchanged names and shared mutual feelings of uncertainty.  I felt much better as some of that awkwardness washed away.  Was it possible for me to be in a class with 95% women and enjoy myself?  After years of working in EMS with 95% men, being the only woman on a fire department, and having mostly male best friends the thought of an estrogen rich class was enough to make me sweat uncontrollably. 

Before Macy and I could get far in our conversation the teacher walked in.  Ms. K was an older woman with glasses and a very classic clothing style that reminded me of a kindergarten teacher.  She greeted us all in such a soft voice and genuine smile that everyone in the room seemed to let out a mutual sigh at the same time.  Tension eased, but only for a second.  Minutes later she began going over our rigorous schedule and syllabus.  We would have two tests every week with two clinical days in between.   Each week we would be expected to read anywhere between two or three chapters or as many as nine or ten chapters some weeks.  The lectures would be three hours on one day and a whopping five hours on the other class day.  I felt myself sweating again. 

Then as quickly as she laid out all her expectations she gave us an assignment.  "Spend the next ten minutes drawing a picture of what you want to do in nursing."  I saw there dumbfounded.  What kind of nurse did I want to be?  I honestly had no idea.  My whole adult life had been spent in and around emergency medicine.  Nursing never crossed my mind until I was married and questioning better salaries and career options.  So I sat and stared at a blank piece of paper for ten minutes.

When the ten minutes was up Ms. K. decided that she wanted every single one of us at all three locations to introduce ourselves, say where we were from, why we wanted to go to school, and explain what we drew.  Crap!  I thought as I stared at my blank paper.  What was I suppose to share?  That I want to be a nurse because being an EMT doesn't pay well enough or have career advancement options here in Vermont?  Was I suppose to say I didn't know what I wanted to do?  I glanced over at Macy's paper and she had eloquently drawn a woman wearing an old fashioned nurses hat and uniform holding two little babies next to a mom reclining in leg stirrups.  My mind blanked.  My armpits were gushing and the back of my neck felt hot.  Embarrassment was imminent and there is nothing worse than first day of school embarrassment.  No one forgets that. 

To my horror Ms. K decided to start in the back of our classroom.  With Macy going first.  Her bubbly personality wasn't fazed by the honor.  As she introduced herself the camera zoomed in on her face so she appeared on television to all the other classes.  Quickly I drew a  nurses face, which was really a glorified smiley face with a nurses hat.  Next to the face I drew a square with the word "Emergency" scribbled in it.  My former art teachers would be horrified.  Years ago I once was a revered child artist, but looking at that drawing you'd never know. 

When it was my turn to speak I remember nothing except feeling as if a heater was blowing directly in my face and waterfalls were seeping out of my pores.  I could see my self on television and my mouth was moving, but I don't have a clue what came out of my mouth.  Something about Jennifer, Maryland, EMS, and my creepy drawing.  Then before I knew it the camera had moved on to the next person and I began breathing again. 

The next hour went on like that. Person after person was awkwardly talking about themselves and their artwork.  I realized that everyone seemed just as nervous and drew just as creepy.  Besides, we were going to school to become nurses not artists. 

Once our grand introductions were over and I had forgotten every single person's name, save for the girl next to me, we were instructed to open our textbook.  I opened my 500 plus page hardcover textbook with a loud satisfying thud.  Had I done any of the summer reading?  Nope.  That didn't matter to me at the moment.  The fact that I had over 250 pages to read in one week before our first test didn't matter either.  I told myself that I could keep up.  I went home later that afternoon and started pouring over my textbook the first evening after class.  It was almost exciting.  The evening was tranquil.  Shawn in his chair, reclined, and watching television with me on the couch, highlighter in hand, happily reading away.

Tuesday, May 30, 2000

Nursing School - The LPN Year Part II

Before we could begin taking care of actual people we had to relearn basic daily tasks and take care of fake patients.  Our first clinical days weren't held at a hospital or nursing home, but rather in another basement of an old medical building.  Surrounded by windowless wood paneled walls we were crammed into this room filled with a few tables, a couple hospital beds, and two very awkward looking manikins.  One manikin had an unruly red wig and unequal pupils that stared at everyone in the room.  I had to position my back to that creepy being, but still felt its eyes boring into my head.

Our very first clinical lesson was how to make a bed.  There is a very precise way that nurses are suppose to make a bed and they include 'hospital corners'.  I barely put in effort to make my bed at home and certainly don't utilize any corners.  Now our teachers, Ms. K and Ms. S., were wielding pens and papers to grade us in our effort to make and remake a bed, first empty and then with a patient.

For the life of me I could not master hospital corners.  We were allowed one "run through" after watching Ms. S. make the bed with Ms. K laying in it.  After my one run through I still had creases in places that shouldn't have had them and uneven edges.  The instructors decided that I was 'satisfactory' and would have to get more practice when we finally went to the nursing home.  I knew I didn't join the military for a reason.

Then we dedicated much of our clinical time to learning how to take vital signs.  Pulses, lung sounds, blood pressures, and counting respirations.  For someone who has been an EMT for more than half of a decade I was well versed in all of these.  I thought that I could help out some of my classmates.  What better way to make friends than by helping them learn?  My teachers apparently thought that was a horrible idea.

With only two instructors for eighteen students to help evaluate and demonstrate taking vital signs most of my classmates were frustrated and left to their own devices to figure out if what they were doing was correct.   I was frustrated because my instructors specifically told me to practice with the class and not instruct other students.  Okay, I thought, perhaps its because it was the first few sessions of class and they didn't know my skills or my medical background.  I was satisfied with my eight year experience of evaluating vital signs so the first day of being shot down and having to prove I knew what I was doing wasn't a huge deal. 

The day drug on.  We were given a break for lunch and allowed to roam across town to forage food.  I had a craving for a McDonald's salad.  It was a phase I was going through I guess.  Thinking I would be nice and more sociable with my classmates I asked if anyone else in the class wanted to join me for a ride into town to Micky D's.  I discovered that was one of the fastest ways to not make friends.  Everyone was utterly repulsed. So I drove alone to retrieve my salad as my classmates went to Taco Bell and Pizza Hut.  I didn't understand why McDonald's was so detested while they ate their cheesy gordidas and I enjoyed a ceasar salad. 

Class reconvened so we could take our math exam.  The class groaned while I secretly beamed.  It was just a simple exam with decimals, word problems, drip rates, and conversions.  All those things I was well versed in.  This math exam was a "pretest" that didn't count for an actual grade, but it was to gauge where our existing math skills were.  I looked at it like a challenge.  Grade or not I wanted to ace this exam.

"No calculators".  Was the first thing Ms. S. said as she shuffled the tests in her hand.  The groans that were only slightly audible when the test was announced were now chorus-like and filled the basement.  When the test landed in front of us we waited for the mark to start and then began.  I tore into the test like a high schooler doing a fourth grade multiplication exam.  In a more nerdy life I once loved algebra.  The long equations were like puzzles to me and getting the right answer after lines and lines of factoring filled me with elation.  So when I was faced with mostly basic math I whizzed through the forty question exam in less than ten minutes.

The instructors were waiting outside for us to come out with our completed exams.  When I came out they were deep in conversation about the morning's practical class.  Simultaneously they turned to me and stared.  "I can't answer any questions" Ms. S. said before I was even withing ten feet.  I smiled and said.  "Oh, I don't have a question.  I'm finished."  And then handed her my exam. 

As if to challenge my brazen speed my teacher corrected my exam right in front of me.  I stood there watching her pen hover across each of my answers, hoping that she did not pause in her fluid movements to mark one of the answers wrong.  After she went through each questions what seemed at least twice she handed it back to me and smiled.  "Good job.  All of them are correct.  You aren't suppose to get a 100% though, its a pretest to gauge where your skills are!. " she said. 

"I just like math I guess."  I said with a sheepish smile.  It made me feel like a nerd to admit that.  Ms. S. just looked at me with a skeptical look.  I am sure she was wondering whether or not I had cheated and used a calculator.  Still no one else from my class had finished their exam and I was left standing awkwardly outside with my instructors all the while hoping they would finish soon.  It didn't seem to me I finished so quickly, but I guess I had.

Finally my classmates started filtering outside from the basement that was our classroom with less than excited looks. It turned out that I was the only student to get every answer correct and the only student who admitted to liking math.  Each person in my class came up to me and commented on how quickly I had finished and that I couldn't have possibly read every question.  'How could I get them all right?'  they asked.  I was on a fast track to being known as the class brain.  In the cut-throatness and sink or swim atmosphere that nursing school would soon take on that was a very good survival skill to possess.

Monday, May 29, 2000

Nursing School - The LPN Part III

The final test of our preclinical clinical skills was our breakfast and bed bath day.  That day was one of that days that they don't tell you about when you are signing up for school.  We were to prepare for our stint in the nursing home by mimicking what we would be expected to do there on one another.  While breakfast sounded nice, it wasn't what it sounded like and the thought of bed baths is enough to fill any self conscious student with fear.

Again we met in the basement that morning.  Each person had a breakfast item in front of them.  There was food ranging from solid fruits to mushy cream of wheat to satisfy all the different forms of diet that a patient may eat.  Rather than just simply enjoy breakfast we were going to feed one another.  Suddenly I wasn't hungry.

All of us were also in various forms of gym clothes.  We were told to 'dress comfortable' in loose clothing that was easy to remove or move around.  Once we had fed one another the plan was then to pair up and give each other bed baths, complete with soapy water and a wash cloth.  I was officially creeped out and began wondering if I could stomach this clinical day.  Unfortunately if I didn't go through with it I wouldn't be able to go on to the nursing home and meet the class requirements.

When the instructors arrived I noticed they weren't dressed in gym clothes like us, but rather in nice business casual outfits.  Apparently they weren't going to be taking part in the "fun" that we were about to.  Instead they set up a table for us to put our breakfast dishes on and told us to go ahead and grab what we wanted to eat.  I thought, oh well maybe they really are letting us eat on our own!

Each of us got up and formed a line.  We picked a plate and filled it with bits of everything then went back to our seats.  Before any one of us could raise a spoon or fork to our mouths our teacher instructed us that we couldn't eat, yet.  "Pair up."  Ms. S. said to us and moved her hands like a musical conductor. I knew that my initial thought was too good to be true and I was about to revert to being a toddler.  Flashbacks of my dad feeding me my mother's horrible pepper steak when I refused to eat as a very little kid flooded my head.  Yuck.  

A woman next to me, who was older than my mother, but a hundred times as hilarious, asked if I would be her partner.  Okay, I thought.  How bad could it be?  This woman had had three children and surely spoon fed them all.  She had to be a good partner.  

We arranged our plates, sat side by side, and stared at each other.  Then both of us began to giggle uncontrollably.  Our instructions were to feed each other breakfast, but we couldn't even get down the first bite.  Ms. S noticed that we weren't on task and came over with a bandanna in hand.  She walked behind me and tied the bandanna behind my head, covering my eyes.  My anxiety increased tenfold.  The bandanna was simulated blindness and my partner had to feed me despite my "disability".  Suddenly I wasn't hungry.

Whether I was ready or not my partner fed me my breakfast one spoonful at a time.  I was so surprised how "forced" a spoon felt when someone else is putting it in your mouth.  Adding the blindfold just made it that much more bewildering.  Even with her constant communication of exactly what she was doing I still was not able to fully anticipate the spoon touching my lips.  Taking a drink was even more difficult.  Almost as soon as the liquid touched my lips it felt as if I was drowning in the cup.  I never could get a full gulp and the drink always seemed to try and go up my nose.  When it was our turn to switch positions I fed my partner with my new insight in mind and all I learned was that I am not ready to feed infants, or anyone else for that matter.  

After a very unfulfilling breakfast we jumped right into the next activity.  Ms. K appeared at the front of the room and told us that we all needed to change into our bathing suits or gym clothes and have our towels and toiletries in hand.  Bed bath time was upon us.  

That morning I had spent extra time in the shower making sure I was extra clean, and smooth shaved.  I was not about to have my classmates sponge bath me prickly and smelly, but the sweating that began as the moment was upon us seemed to work against my vigilant showering before class.  I heard another girl behind me joking about the same thing, how she shaved this morning just for the occasion of bed bath day.  She was laughing and seemed so at ease so I asked her if she would like to be my partner.  We were close in age and size so I was hoping the awkwardness would be at a minimum.  At least with her secured as my partner I wouldn't be paired with either one of the two men in the class.  A married woman just doesn't feel comfortable with another man washing her body!  

Fortunately we weren't washing the unexposed areas under our clothes.  Only extremities, part of the back/shoulders, and the face were really focused on.  All the rest was to be kept covered.  I breathed a sigh of relief.  

My partner, Cathy, and I talked and joked with one another while waiting our turn so when it came time for us to go over to one of the two patient beds in the classroom and give one another a bath we were slightly more at ease.  I hopped into bed first, just wanting to get the awkwardness over, and let Cathy sponge me with a wash cloth using the body wash I brought from home.  Ms. S. stood perilously over both of us watching every moment made.  In the middle of having my face washed Ms. S leaned down and looked at my face closely.  I was wondering what the heck she was so concerned about on my face or if I had some breakfast left that I didn't know about.  "Wow, you have very pretty eyebrows Jen!"  she said with a smile.  All I could do was laugh.  I couldn't take the rest of the experience seriously.  

After I was towel dried I then was given a backrub and had lotion applied to every extremity.  I learned that a backrub is actually an integral part of nursing care.  It is suppose to be done at least once a day for every single patient whether in long term care or a hospital.  I practically fell asleep as my partner did an almost professional seeming job on the massage.  It was almost worth going through the bed bath, almost.

Then I had to break the relaxation and switch places.  It was my turn to wield the wash cloth and soap.  Cathy laughed the entire time and had a conversation with me like we were sitting at a cafe sipping on coffee rather than me scrubbing her with a wash cloth.  My mind went on auto pilot and I didn't think about my actions, but rather removed myself and had a normal conversation.  It is akin to the way the a mortician can make a frank joke and hold a conversation about death while embalming a body.  

Once everyone had finished scrubbing one another down and the basement smelled like a mix of lavendar and old spice we had just one assignment left.  A basic math instruction followed by a test.  We were to do basic decimal conversion such as how would 4/10 be written as a decimal?  And how many kilograms are in 500 grams?  Easy as pie.  

Again I was the first person to finish my test and walked out of the basement to sit outside.  The fall air felt wonderful on my freshly sponged skin.  I sat on a picnic table and waited for the rest of my classmates to come out.  As they trickled out on girl came out complaining how another student, John, had spilled his coffee all over the table. Did it make a mess?  I asked.

"Well he cleaned up the table.  It got the corner of my medical math book wet." she said.  I hadn't been sitting near him so I didn't think anything more of her spill except laughing a little at his clumsiness and her annoyance.  When we went back into the class room I went to put my notebook back into my backpack that had been on the floor at the edge of the table all class long.  As I looked down I noticed there was coffee completely covering the inside  of the backpack.  He had spilled his coffee in my backpack, all over my books! 

I hunted down John, who was outside casually sipping on what was left of his coffee, and confronted him about the mess he had made.  He stuttered and shrugged it off.  I fumed and stomped back into the classroom.  The older woman who was my breakfast feeding partner saw me steaming in anger as I grabbed an entire roll of paper towels to mop out the mess and dry my books.  She came over and helped me clean things.  The anger subsided, a little. 

My obsessive compulsive self was still very upset.  One of my textbooks, the medic math book, was completely trashed by the coffee.  The edges were already starting to curl and some of the pages were stuck together.  I couldn't tolerate a book in such condition.  Almost as soon as I started complaining the woman helping me clean took the book from my hands, went to her tabled, grabbed her book, and shoved that one at me in its place. "Keep mine."  She said.  "I don't mind a little coffee."  and she smiled.  How nice of her!  It was definitely more than a little. 


Despite all the awkwardness the day wasn't as dreadful as I had anticipated or it could have been, even though I don't drink or care for coffee at all.