Dyspnea, Orthopnea, Eupnea

I had to take a Medical Terminology class to fulfill the requirements for my degree. I thought it was kind of silly and somewhat of a waste of time, but, hey, I can’t argue with an easy A.

My class was online. However, we had to call the instructor once per week to read medical words from a vocabulary list she’d emailed to us. When I called her for the first time, she went off on this huge tangent about how she has all this experience in the medical field, but she never specifically discussed what job(s) she held.

One day, I called her to complete this assignment. I was reading down the list, not thinking much of it.

“Hypoglycemia,” I’d announce.

“Good.”

“Humerus.”

“Good.”

“Dyspnea.”

“Um….try that again.”

 

I was kind of surprised. I didn’t think I’d mispronounced anything.

“Disp-nee-uh,” I tried a little slower.

“No. Minus 5 points. It’s pronounced dis-pee-nee-uh. You need to pronounce the ‘P’. Next.”

Huh?

“Um…ok…orthopnea.” (Orth-op-nee-uh)

“Again, pronounce the ‘P’. Minus Five again. Orth-o-pee-nee-uh. Next.”

“………….Eupnea.”

“Pronounce. The. P. Ee-you-pee-nya.”

“Interesting,” I said, carefully choosing my words. “I’ve never heard it pronounced like that before.”

“Well, when you’re in the business for a long time, you pick up on these things.”

“I see.”

 

Maybe I–and everyone I’ve ever worked with or been exposed to in the medical field–is wrong? But I’m willing to bet you all (y’all, yous guys, etc.) pronounce it the same as I do, despite the differences in our colloquialisms. That’s just me though. Feel free to correct me if I’m wrong. Because she definitely did. 15 points worth of it, actually.

Finals Week

 

 

 

Chocolate

 

Why, yes, it IS finals week! How did you know?

This, incidentally, is just the junk food I have left over. I’m hardly even mildly ashamed of this. What can I say? I like to give all that stress-related cortisol something to work with.

Anyone, posts will be kind of spotty until I have officially survived my first year of nursing school. I know, spotty has been kind of my new norm lately, but I hope to change that soon. I’ve got plenty of things I’m looking forward to writing about.

Anyway, thanks for your continued support! Wish me luck! See you on the other side 🙂

Unprofessionalism in Education

We’re gonna play a little game today. Yep. You and me. I’m going to write a quote here that took place at school the other day, and you’re going to guess who said it. Okay? Great!

“So Elise emails me this question the other night, asking me about complications of placenta abruptio. (laughs) Seriously? How do you not know this? Like, really? How about bleeding out, Elise? That’s gonna be a pretty big problem pretty quick if you don’t see what’s so wrong with having placenta abruptio. I can’t believe she asked me that.”

You probably have a decent picture in your head. Some mouthy nursing student (similar to ones I’ve previously posted about here and here) that has nothing better to do with her time than put down the others, most likely because she’s insecure herself. But you’d be wrong.

That quote was from one of our teachers.

That really grinds my gears. I am somewhat shy, but I used to be much much worse. Speaking from experience, shy people can get incredibly uncomfortable about asking questions in a public forum (ie, a classroom.) Why? Because we’re afraid everyone’s going to think we’re stupid. At least that was my fear. So emailing a question is a nice, private way of learning while successfully avoiding judgement. Right?

Wrong, apparently. I guess now it’s okay to make a mockery of a student by name–who fully intended to speak with you privately–and flaunt it to other students. I’m proud to say that none of the students in this room so much as chuckled. No one said anything. We all just stared at her, occasionally exchanged glances with others, and waited for her to finish her rant. When she was done, there was an instantaneous understanding amongst all the students in the room. We could never feel comfortable asking her questions without fear of her making fun of it to other students. Creating an environment that discourages questions from being asked is to essentially kill off the possibility of gaining a full and comfortable understanding of subject material. Inquiries are at the heart of learning. And now, everyone is afraid to ask. Super.

I’m completely disappointed and continuously discouraged every time something like this happens. To any of you educators out there, I am begging you…please never do something like this to your students. Ever.

Are You Taught To Hate Your Field?

Why on earth is the healthcare provider education system so hell bent on burning people out before they’ve even got their license in hand?

At least that’s the way it seems. Maybe it’s just a regional thing. Maybe all the schools in my area are teaching using similar techniques, and all the teachers subscribe to a similar mindset. Or maybe I’ve officially lost my mind (I am certainly not ruling that out).

This post is going to mostly be about nursing school, because that’s what I’ve experienced. But, any new-grad paramedic I know has talked about similar problems.

For any of you that actually read my rambling, babbling, nonsensical drawl, you know that I am unhappy in nursing school. Yes, I do feel absolutely miserable. Every week, I find myself up in the wee hours of the morning on the verge of a mental meltdown. Every drive to school is filled with anxiety, and every drive home is filled with discouragement. It feels almost like a trap some days. The further into the program I get, the worse I feel, but the more obligated I feel to finish it. At my worst, I find myself panicky, physically sick, unable to sleep, and waking up with horribly graphic and disturbing nightmares. Sometimes I start wondering why I ever decided to go into nursing. In my stress, I start to look for other careers I could do. Maybe I’ll find my calling in something else. In the past, I’ve considered going to paramedic school. Currently, I have some wild aspiration to go into law enforcement…which I’m sure would be greatly discouraged by anyone who actually knows me. I have to stop and wonder if these aspirations are real, or if I’m just looking into them because it’s something other than what I’m going through right now.

I’m in an associate’s degree program, so it’s only 2 years long. Most paramedic programs are about that long as well. It’s a short amount of time in which to learn a lot of important things. It’s not like earning a typical degree…after we get out of school, our decisions could greatly impact the lives of others. The stakes are very high, and it’s incredibly important to learn as much as we can in the short time that we have. Maybe these programs are just too short to be reasonable. I find that students in these shorter healthcare degrees/certification programs are just so stressed out and inundated with schoolwork that they find themselves discouraged or disliking the career they are about to enter. It’s heartbreaking to work so hard towards something, and then to be almost directed to hate it.

Maybe I just don’t love my potential career enough. Maybe I’m not dedicated enough. And like I mentioned before, maybe it’s purely a regional thing. Regardless, something should change here. Maybe it’s just me. Or maybe it’s the healthcare system. Or perhaps something in between.

Are any of you having problems similar to this? Or did I really just plain old lose my mind.

My First NREMT Cognitive Exam

Although the calendar had just flipped over to September, the weather still remained unforgivingly hot and humid. It was my first week of college, and my first week out in the big bad world all by myself. I knew absolutely nobody in this city, and I was hours away from anything remotely familiar. So far, I was making the best of it. I was excited and ready to prove to the world that I could do grown up things. Because, obviously, at the age of 17, I was pretty much a full-fledged adult.

On my list of grown-up things to do was to go and take my computer-based test for my First Responder ticket. I’d taken the class back home during the summer, seeing as I wasn’t quite old enough to take my Basic course. All that was left between me and my first EMS provider license was a computer test.

Being a college freshman in a city, I had no car. I had already taken a taxi once before that week, and that was a disastrous decision. It’s just too intimate a setting. Call me crazy, but there’s something unsettling about being trapped behind plexi glass, in a locked vehicle, being driven by a stranger listening to tympanic membrane-rupturingly loud music, that occasionally tries to scream-ask me questions like, “DO YOU LIKE SAND CASTLES, SWEETHAHT?” Also, the posted sign that says “There is a $50 fee for vomiting in the back seat” is there for a reason. They didn’t just opt to put that there one day. It actually happened. Right exactly where I’m sitting, most likely, seeing as there’s really nowhere else to go.

Long story short, I hate taxis, and try to avoid them. Which leaves me with the bus system. I had spent the entire long, sticky, swelteringly hot night before the exam peeling apart the bus schedule brochures I found in the lobby of my residence hall. It all seemed to be working out perfectly. I had enough time after my chemistry class to walk over to the bus stop, take the bus to the center, test, and be back in time for dinner.

I couldn’t sleep at all. Well…partly because it never got below 102 degrees in my dorm room that night. But even if the temperature had dipped to a more sleep-conducive level, my excitement and nerves still would have prevented me from getting much rest.

After my chemistry class the next day, I swung by my dorm room to drop off my books, pick up my exam entrance ticket, and triple-check that I had all the appropriate forms of ID. In what was one of the two acts of kindness my roommate had displayed all semester long, she left me the last apple we had left (we really needed to go grocery shopping) with a note that said, “Good luck!” After slinging my purse over my shoulder, I grabbed the apple and set off into the stupid hot afternoon sun towards the bus stop.

The thing about bus schedule maps is that they don’t give you nearly as good of an idea about distances as you’d assume. They also don’t account for the additional travel time needed for an anxious, sleep deprived girl who’s well on her way to heat exhaustion. Nor do they give any indication of changes in elevation–suprise, cities aren’t perfectly flat.

I thought doing something other than walking would help calm my nerves, so I ate my apple on the way….really fast. Before I reached the end of the first block, my now cramping stomach was filled with butterflies and golden delicious apple. I get super queasy when I’m hot, nervous, or tired. I happened to be all three, so I spent most of my walk trying not to wretch, and/or die in the 105 degree heat. Later that day, I would consult Google maps to find that I’d walked about 1.5 miles to get to the stupid bus stop–while apparently passing several other bus stops that would’ve taken me to the exact same place.

When I finally arrived, I stood in the baking sun, absolutely pouring with sweat, waiting for the bus. I felt dizzy, realizing that I hadn’t had anything to drink all day. The sizzling waves of heat floated above the pavement, making me question if that was normal, or if I was about to pass out. I was unapologetically mouth-breathing, and trying really hard to make my retching as discreet as possible. I checked my watch, and saw that the bus was probably about 15 minutes late. I was sick, tired, a little lost, and alone in a city where I didn’t know a single person to come help me. A part of me wanted to cry, give up, and go back to the dorm. The other people waiting for the bus shuffled away from the crazy-looking chick with the sweaty eyeliner running down her face. Except for one brave individual, who decided to get sociable with me. Probably out of pity.

“So where are you going today?”

“To take my first responder test…” I panted. She gave me a quizzical look. “It’s like an EMT, only you can’t do as much.”

“You look like you need an EMT yourself. You want me to call you an ambulance?”

“Nope. Definitely not. Thanks.”

By the time the bus did show up, I almost forgot why I was there. I was just so overjoyed that I was about to get on something with air conditioning. When I stepped onto the bus, I fumbled around, looking for my student ID (which provided free bus fare). The bus driver chuckled and said, “You aren’t from around here at all, are you?”

“Nope,” I said sheepishly. “Actually, maybe you could help me. I’ve never taken the bus before. Obviously. Can you let me know when we get to this destination?”

Surprisingly, he happily obliged. The woman I chatted to at the bus station told the driver, “She’s going to take her EMT test.”

I shuffled my way to the back of the bus and clung on to the overhead bar for dear life. The tall towers of downtown started to shrink away into dilapidated buildings with rusty metal bars over the windows. Angry looking people hung out on stoops and street corners, glaring at those who walked past. Abandoned cars with broken windows lined the streets. The lights of police cruisers glittered down a side street. I couldn’t be 100% sure, having never really seen them in real life before, but the signs and walls of buildings seemed to be full of pock-marks and bullet holes. My heart pounded away in my chest. Oh, God, where am I going? What am I doing? I’m not ready for this at all.

When we finally arrived at my stop, the bus driver called out, “Miss? Your test center stop!” I made my way off the bus, and stopped to thank him before leaving. He yelled out to the rest of the bus, “WISH THE KID GOOD LUCK! SHE’S GOING TO TAKE HER EMT TEST!” To my surprise, the bus erupted with loud cheers and well wishes. I smiled and scurried off the bus. It certainly made me smile…but now I had that overwhelming terror build up inside me. I was about to go take the test that justified all my hard work all summer, and all the craziness of getting to this testing center, which was apparently in the bad part of town.

A week later, much healthier, and many degrees cooler, I received a letter from home. Sitting on my bed, I opened it up.

“Probie To Pracitioner, Congratulations on passing the National Registry of Emergency Medical Technicians First Responder…”

I beamed. Yep. Definitely worth it.

Paramedic or RN?

Well, here we are again, internet friends. Back to the soul searching and looking for advice from my favorite anonymous third party!

Firstly, if you’ve been following my whining about nursing school, you know I’ve been dealing with several really mean individuals. I’m happy to report that most of them will not be in my class this coming semester. Yay! There’s something to be said about karma, I suppose. Well, that and hard work.

During my Christmas break from school, I picked up more hours at my department. Going back and being able to do something I love…that all by itself makes me happier. Plus, trying out my new ALS skills has been really exciting too. Anyway, with all of these additional hours, I’ve obviously been to area hospitals more often, and to the local nursing homes as well. It just seems to remind me more and more that EMS is where I belong.

That, combined with some major screw ups at my school (losing my tuition, for instance) is making me rethink the whole nursing thing. I’m planning on applying to transfer…the problem is, should I transfer into another nursing program? Stick with it? Bridge to paramedic later? Or scrap it, become a paramedic, and bridge to RN eventually? It seems like the RN-first path means I’ll have lots of years doing things I hate in order to get where I really want to be (pre-hospital medicine, although ER would be fine too). Paramedicine, however, means putting my time and energy into a field I love.

I understand the RN position would be more financially stable, and I would have the opportunity to change specialties and get out of the emergency scene if it gets to be too much for me. But the idea of being a paramedic still pulls at me. So, here we are. Paramedic? Or RN?

 

Overheard at the Station

Cop: Hey, how’s nursing school?

P2P: Good. To be honest, some days I’m sitting in class, staring at my pencil, and considering giving myself a lobotomy with it because that would be more fun and less painful…but, overall, no, it’s not too bad.

Cop: Yeesh. Well, I’d rather have a bottle in front of me than a frontal lobotomy. Good luck to you.

Freshwater Sharks

One day, in my EMT class, our teacher went off on this scenario. He was talking about being on some rescue saving some guy in some lake in some town somewhere else. I think the point of the story was that you needed to think ahead and consider what resources you might need to call for in such an event. So he asked us what we’d need to consider before and while arriving on scene.

“Well, I’d want some sort of police protection. Or a hunter. Or fisherman,” This student said. We all sat quiet, waiting for his rationale. “Gotta watch out for those sharks, man. No sharks. Scene safety.” We all subtly looked at each other.

“…Okay. Uh…interesting thought. But it’s a lake,” The teacher replied cautiously.

“Yeah, and it’s a shark. I don’t mess around with those things. Too many teeth.”

Proud Moment

“Do not, under any circumstances, wear anything suggesting you are an EMT,” My partner told me upon hearing who my A&P professor would be. “No uniforms, no t-shirts, no job shirts. None of it. She hates EMT’s. She finds that out, I swear to you, she will make your life a living hell.”

I told him I wouldn’t. I figured he was probably overreacting; but when I got ready for my first class, I made certain I wore nothing that even remotely hinted at my line of work. When I got to class, I found a girl wearing her private EMS uniform sitting at a bench seat. I introduced myself, and we quickly became friends and lab partners.

It didn’t take long for me to see why my partner had warned me about keeping my career a secret. During one of our breaks, a kid started talking about a car crash he was in recently, and mentioned the ambulance ride.

“EMT’s are people who couldn’t qualify for nursing or medical school,” Our professor matter-of-factly sniffed.

Oh. Well okay then.

I never made mention of my work. My lab partner, however, showed up to class regularly in her uniform, as she came off shift just in time to scramble over to the lecture. To my surprise (and confusion/disgust), I noticed a weird double standard. When a test was passed back, my partner asked why one of her answers was wrong. The teacher simply stated, “If you’d studied more, you would know why.” However, if I asked a question, I would get a cold, somewhat confusing response. It was something though, even if it was just a convoluted, highly cerebral answer. More than my partner appeared to be getting anyway.

A few weeks into class, this double standard came to a head. A nearby city experienced a natural disaster, and resources were pulled from the surrounding areas. One of said resources was my lab partner, who was held over for hours after her shift ended, causing her to miss class. Now, we were taking an accelerated class. Missing one day was the rough equivalent of missing 1.5 weeks of a regular class. When my partner showed up for the next lecture, the professor chewed her out for missing a class and not taking her studies seriously. The EMT explained that she was sent out of her district for this disaster, and it was something that could not be helped. Our professor shrugged her shoulders. When asked if she could spend time with the teacher after class, our professor said that she would not make such concessions for people who didn’t take her class seriously. At the end of lecture, my partner gave me a hug good bye, saying she was dropping the class.

“I can’t afford this. I’m losing money by turning down shifts for this class. Getting any help here is like pulling teeth. She is probably going to fail me anyway. I’d rather cut my losses, get some of my tuition back, and get back to work. It’s not fair,” She told me.

Class continued on, but a fire burned inside me.

On the day of the final, I walked into class in my full duty uniform. The professor handed me my final exam, all warmth and smiles. When I returned the completed test to her, she smiled.

“You’re a firefighter? How noble,” She said, noting my fire department patch on my arm.

“No, I’m an EMT at a fire department,” I evenly replied.

“Oh, and how long has this been going on?” All the warmth was gone from her voice. And what an odd response…like I told her I’d been cheating on her or something.

“Over a year now.”

“Is this for medical experience until you get into nursing school?”

“Well…I don’t want to speak for the future. But I really like EMS. And I’d like to stay in it for as long as I can.”

“Oh,” She wrinkled her nose. She shook her head and let out a disapproving sigh that just said, “What a shame.”

I passed that class with a 91, thankyouverymuch. I hold that memory with a certain pride. But what makes it better? I was on my way to my nursing class the other day, coffee in one hand, notebook in the other, backpack on my shoulders, student scrubs on my back. My A&P I professor came around the corner just before I went into my classroom. She looked me up and down, noting my scrubs. I nodded in acknowledgment. She nodded back.

Score one for EMS.

The Lucky Patch

I work with a paramedic who also teaches. He told me a story one day that inspired me.

Back in the day, he was teaching a paramedic class. It was tough, as good paramedic programs are, but the students were managing. Well, most of them. One student just wasn’t getting it. It wasn’t for lack of effort, or desire, or motivation. The guy worked his butt off, but he just wasn’t getting it. One day, he pulled his teacher aside. He wanted to be a paramedic so badly. There was nothing he wanted more. And yet, despite his best efforts, he was doing terribly in class. It was discouraging, to say the least.

The teacher thought it over. A couple of classes later, he pulled the student aside. He handed him a new, shiny, gold disco patch. That very thing this particular student craved. His eyes widened. Taking it cautiously, he offered a confused expression to the teacher.

“You can’t wear it. You can’t sew it to anything, or display it. You can’t be telling others you’re a paramedic, or giving that impression with this patch,” The teacher said. “But, you can have it in your pocket. You can know that it’s there. And, when times get tough, and you have a moment alone, you can take it out and look at it, and remind yourself why you’re doing this, and why you’re going to make it.”

The student did just that. He kept it in his pocket at school and during clinicals. When he was home, he kept it on his dresser. There were times that he doubted himself, for sure. There were rough nights of studying, long days of class, frustrating shifts of clinicals. But that patch helped him.  He did ultimately make it through paramedic school. Now, he can wear a gold patch on his arm.

 

Nursing school started last week. I have two 3-hour lectures a week, plus an 8-hour lab. When I’m not at school, I’m either driving, working, sleeping, or studying. Which would explain my lack of posts. And my soon-to-be lack of sanity. Things are stressful now, but certainly do-able. But I know it’s a matter of time before my faith in myself starts to wane. Before I start to wonder if I can do this, and how I’m ever going to make it. I look at my 13 textbooks, and the pages upon pages of notes I’ve already written. Once already, in the middle of a 100-page reading assignment (due 32 hours after it was assigned. Along with 15 pages of med math, 15 pages on cultural awareness, 40 pages of pharm, and 30 pages of nursing diagnoses), I began to wonder if this was ever going to end. And we’re only on week one. I have a long way to go.

But, that paramedic’s story stuck with me. I have a little pin that I fasten to the inside of my innermost pocket on my uniform. It has been with me at every class and every lab, and I plan on keeping it on me for the rest of my nursing school career. It’s just a little thing to keep me going, to keep me focused. Somewhere out there, way off in the distance, is a light at the end of the tunnel. In the meantime though, it’s nice to keep just a little torch by my side.

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