Wednesday, April 11, 2012

How to Frustrate Nursing Students 101

I am too tired to get my Irish up tonight. Yesterday seven of my classmates and I worked a twelve hour hospital shift, and were still required to get up early today to attend a special class. Sometimes these things happen, so it was not the class that bothered me but the fact that, if my Well-Respected Nursing Program had the proper number of clinical instructors and a better sense of how to run a nursing program generally, we would have had an eight hour shift yesterday, a day to study for our upcoming leadership exam, and another eight hour shift tomorrow, fulfilling both our need for study time, our requirements for a certain number of clinical hours, and our apparently ludicrous expectation that these hours would take place in an actual hospital.


Instead, we attended an eight hour discussion of why hospital births and pain meds are the devil and home births are the duty of every modern woman. Now, as both a modern woman and a modern medical consumer (and most importantly someone paying large sums of money for a supposedly quality education), I expect to be given information by my instructors in an unbiased format, or at least both sides of a controversial argument.


It is clear there are many good things to say for a midwife-assisted home birth, a birthing center birth, or even a midwife-attended hospital birth, but equally clear that the arguments "this is how women have done it for centuries," and "in 1900 almost all births were home births" are inadequate to support a valid practice. Women and infants have also died in childbirth by the thousands for centuries, and as a friend pointed out, in 1900 almost everyone also had poor dental hygiene, but we don't consider this to be a good thing. 


The fact that technology can be brought to intervene in a natural biological process does not make the use of that technology necessary or sometimes even optimal, but it absolutely does not mean that it should not be used. Surgery used to be done with a swig of rum instead of anaesthesia; that doesn't mean we should go back to basics with that. Children used to get the measles right and left but no one is advocating for little red spots either. Sonograms, amniocentesis, and genetic screening are all recent editions to pregnancy but the latter two are invaluable tools when conceiving and carrying a child, and Facebook is nauseatingly plastered with proof of the world's adoration of sonograms. So why the insistence on rejection of modern options for birth?


I do not suggest that every woman who gets pregnant should be summarily C-Sectioned so they can make their 4:30 hair appointment. Many women are perfectly capable of giving birth with minimal, if any, intervention, and in their home if they so choose. It is not unreasonable for a healthy, low-risk mother of one or two to decide she is ready to go au naturale on the next baby, and this should be encouraged for all kinds of reasons (personal comfort, financial, family bonding, keeping healthy people out of the hospital, etc.). But there is absolutely, positively, under no circumstances, ANY EXCUSE whatsoever to present hospital birth as some sort of aberration. 


A recent film by a C-list celebrity explores the touchy-feely-magical lifegiver side of birth, and lays it on pretty thick against anyone who would even remotely consider the idea of an induction, C-Section, Pitocin-assisted labor, or a medical degree in the room. The single doctor interviewed who supported hospital births was made to look like the sort of person who would prescribe laudanum for a woman with the hysterical vapors. At the opposite end of the spectrum was a man who genuinely voiced the opinion, and I am not exaggerating, that receiving an epidural renders a mother and baby unable to love each other properly. 


Now, my mother had me naturally, but received epidurals with both of my brothers, and certainly does not love them any less, or any differently. I guarantee if she is ever annoyed with one of them it is because he has left piles of moldy dishes in his room, not because she had an epidural twenty-odd years ago at his birth. Moreover, I also have a stepmother who loves us totally and unconditionally without us ever occupying her womb. Both she and my mother would quite cheerfully kill anyone who suggested that they didn't love us correctly because they did not have an authentic log cabin, peat fire, grannie-delivered birth. Furthermore, there are millions of adoptive parents and billions of fathers all over the globe who love their sons and daughters with every fiber of their being (my father included) and they clearly did not physically birth these offspring.


Birth IS an emotional experience for the parents, a major change in the life of the family, and an intense physiological process. It is not, however, magical or mystical or some mysterious thing to which only certain women have the secret key, and which modern medicine and the Male Establishment have ripped from them. It is not necessary to treat it as a medical emergency (although some can be), and the woman as an ill patient, because pregnancy and birth are not afflictions, but neither should we reject all modern medical resources simply because chimpanzees struggle to bond with infants born via medical intervention (another fine scientific opinion offered in this film, despite the little-known fact that the simian spine is configured differently than a human's to permit far easier birth, and the more obvious fact that chimps do lots of things humans don't do, like eating lice and throwing poop). 


Having teeth is not a medical affliction either, but I still see the dentist in her office rather than my bathroom. And if I do need work done, I want her to use Novacaine, not just climb in there with a pair of horse calipers. It seems quite logical that using the tools at one's disposal, as and when they are helpful, is a sensible thing to do, whether that tool is an ordinary one for a mundane task, or a complex one for an involved process like delivering a baby.


In summary, does it matter, one woman's foolishness? No, but it wasted my day and that of fifteen of my cohorts, all of whom also have a leadership exam on Friday, eight of whom have to get up at 4am tomorrow for their twelve hour shift, and at least one of whom has given birth via C-Section and does not struggle in any way to love her children. It also demonstrates the flaws inherent in my Well-Respected Nursing Program, which sadly all of us are now simply too exhausted to fight. The End.

Friday, April 6, 2012

Weekend Book Recommendations!

Still love books. Here are some more for you to love too. That is all.


Shark River (Randy Wayne White): #8 in a series, but they read easily out of order since the narrator (full-time marine biologist/part-time knight errant) is always alluding to things that happened in previous books or distant past. This one involves a Jamaican woman claiming to be his sister, an interrupted kidnapping, and the main character's usual slightly-excessive soul searching, but it's worth reading just for the descriptions of the Florida Keys scenery.


The Man With the Golden Torc (Simon Green): Adventures of a secret agent-boogie man hunter. Funny if implausible, have heard Green's other series is better but I thought this book (1st in its series) was great. The whole series is named after Bond movies, which is also good.


The Sign for Drowning (Rachel Stolzman): A sign language interpreter adopts a Deaf girl and finds some closure for her sister's childhood drowning. No tissues required: simple but interesting plot, low-drama daily life, and even has a happy ending.



Tuesday, April 3, 2012

The Sense God Gave a Billy Goat


My Well-Respected Nursing Program is suffering from a lack of...well, different things on different days, actually. Some days, money; many days, common sense; most days, decent faculty - and proper communication skills? Every damn day.

I am so excited to be a nurse soon that I can hardly stand myself, and am grateful for the opportunity/good fortune that enabled me to pursue it, but this program is, as a classmate recently observed, begun in confusion and will end in disarray. I wish I could give them the benefit of the doubt and say that my Well-Respect Nursing Program is an example of many very intelligent people being better at thinking deep thoughts than organizing a nursing school, but sadly the fact of the matter is that not one iota of this program has the sense God gave a billy goat. 

Disbelief? Decide for yourselves. Here is but a sample of their usual behavior: 

December: We break for the holiday without an assignment for the spring semester's clinical placements. There are fewer than 50 in my class (split into 6 groups, two each assigned to psychiatry, pediatrics, and obstetrics, which will rotate every 5 weeks) but with several other nursing schools in the area it takes time for the local hospitals to tell each how many students they can take, so we were warned this might happen.

January: We return to school FIVE WEEKS later with still no information on the clinicals and are sent to a new Blitz where we’re informed that we have only half as many clinical instructors as necessary because they all bailed out of their contracts to work at private nursing schools. Only a third of us, those on our psych rotation (including me), will go twice a week as planned, the other two thirds will go to pediatrics or obstetrics only once a week. To make up for the deficit in hours, the peds group has to do an out-of-class project (“the Denver”) and the OB group will do 12 hour days. Our clinical director orders our psych instructor  not to give anyone A’s, and denies doing so when confronted about in front of the dean.

Early February:  Just before we swap rotations additional instructors are hired so we’ll all have twice-weekly clinical, except due to their schedules the new pediatric group will have one instructor on Tuesdays and a different one on Thursdays. The original peds group still has to do the Denver but the new one does not, the new OB group will have regular 8 hour days, and our hospital assignments are rearranged to accommodate the change. My pediatric group is told we will be going to one hospital, then receives an email welcoming us to a different one, and the night before we are due to begin the new rotation are officially confirmed for the original hospital.

Late February: Syllabus has been sliced and diced so many times in previous years and the last 2 months we ask for a new one. New OB instructor quits after 2 weeks. Half of the OB kids are back to 12 hours a day once a week. The rest of us are not told how this will affect our hospital assignments.

Early March: The peds group (mine) asks for clarification on three very similar projects and are awarded a new, more massive, project (including a presentation on our day off) for our efforts, plus no clarification on the original three. This project is invented and passed along to us by an instructor fired the previous semester for being a generally terrible teacher and human being (she was kept on the faculty for “special university projects”, presumably a re-education regime of some kind).

Late March: We devise a way to combine all the projects into one coherent one and receive permission to make the change. For reasons unknown to us, our clinical director, who has never seen us in the hospital setting, will be grading it instead of our instructor, who sees us every minute of every day. At least there is no mention of not receiving A’s.

Later March: Our clinical director claims not to remember the project change. We do it anyway because it is far too late to do anything else. The other half of the peds group does something entirely different and we are somehow graded as doing to same type and amount of work, by someone who has never seen any of us work. Still no idea what hospital we are officially assigned to for the next rotation but local rumor supplies a plausible candidate. Never did receive a new syllabus.

Early April: About to swap rotations the final time and half of us due to begin the OB rotation receive an email saying they will be back to 8 hour days twice a week at the hospital the other half of us were assigned to. My half of the group receives nothing. The instructor for that hospital says her information jives with the email, and the clinical director is unreachable.

It is currently less than 48 hours before I am due to begin my OB rotation and we are still unable to confirm which of us are assigned to which hospital, under which instructor, how many hours a day or how many days a week. I rest my case.