Oh where, oh where, is all of my hair?

Mid-April was the beginning of my downward spiral. I was beginning to ignore my house, my kids, my love of couponing.... everything. Every meal consisted of either fast food or snack food. I quit paying the bills and even bought milk through the drive-thru to avoid going to the store. Living and breathing became a chore, and the desire to be a good mom faded into the background as I struggled to understand the chain of events that led to my demise. I've never been a fan of anti-depressants, but the pain caused by my deep depression was starting to affect every aspect of my life. When you here the phrase "depression hurts", it really does. I had always believed it to be an expression, but I actually experienced real, physical pain. Knowing that I needed help, I swallowed my pride and made an appointment with my doctor.

I didn't realize that my hair pulling was an issue until it was clearly visible and my scalp was smooth to the touch.

My doctor prescribed Zoloft for me and told me that the hair pulling (trichotillomania) was caused by the development of a  new anxiety disorder. The Zoloft, she said, would help with both the depression and the anxiety.

This is what my scalp looked like during the second month of my Zoloft treatment. I could no longer  hide my disfigurement- ponytails were not an option anymore. From this point on, I was a hat owner- and I wasn't very happy about it.

Next post: Trichotillomania

She must need hearing aids because she sure as Hell isn’t listening to anything that I have to say

The class started out okay. I didn’t talk much. I was still jaded from my first attempt. I missed the first day of class due to my 3-year-old son turning off my alarm clock. As luck would have it, it wasn't the first time that that had happened to me. It also happened during my first attempt at NSG 222. Irony is a strange thing.... Anyways, I emailed her to let her know what had happened and got a generic reply. She had moved our classroom for the next day but did she tell me in her reply? Hell no. That would've been the NICE and PROFESSIONAL thing to do. Instead, I missed an hour of class the next day as well because I had no idea that the room had changed. Nice.

Things started to go really bad for me after I challenged a questionon the second test. Prior to starting the quarter, I was advised by others notto challenge anything with this instructor. Before speaking to my instructor, Iconsulted another nursing instructor that I know outside of the program. Shetold me that she thought my rationale was good and that I should question it. Iapproached the situation very carefully, and was delicate with my choice ofwords. Here is a synopsis of the question:

You have a laryngectomy patient. What intervention would you teach to promote mucous membrane integrity?

A. Drink 8-10 glasses of water per day

B. Take steamy showers

C. something

D. something

The answer that she had was A. My answer was B, because there was no mention of how long post-op the patient was and I had to go with patient safety. The response that I got was anything but reasonable. She said that allof the answers might be poor but that I needed to figure out what the bestanswer was. No ifs, ands, or buts. She wouldn’t listen to my rationale and cutme off right away. She said that I should have ASSUMED that the intervention was for a long-term patient. Ummm... okay.... maybe if we were talking about home care, but in the hospital setting I'm going to be teaching the patient how to stay alive. I was shocked to say the least. I pay tuition to come hereevery day and work my butt off, not to be treated like a high-school studentwho has no choice but to come. I knew going in that she was probably going tobe sarcastic and rude, but I still expected her to at least listen to me. The first time doing med recall with her was also a disaster. I was going over Heparin with her when she interrupted me by asking me what she called a "HIPPA rule". I kept saying things like, "Check the patient, check the ID band...". She wanted me to change the needle, which if I can recall correctly, has NOTHING to do with HIPPA. Before this incident, she hadn’t written much on my process tool. Now all of asudden, everything’s wrong and I’m incompetent. Besides not hearing me out, shewasn’t even reading my process tool. I have two examples specifically of thisin regards to her not reading what was on it, and one good example concerningmy performance check-off. I was given my scenario with no written or verbalinstructions, so I just did what my previous instructor had told me to do. Shesaid not to worry about the lines, and to just write down what you would do inorder and write your rationale beside it. I had seven actions total, my fiveskills and two assessments. I was really trying to be as thorough as possible.I can’t remember specifics about my scenario, but the short version is that mypatient had CHF and the respiratory therapist is in the room suctioning when Icome in. So first I put “assess lungs and oxygen status” and then I put that Iwould give the Lasix IVP and so on. She sees my scenario and sees that I haveseven “actions” and starts to get upset that I didn’t use the five lines. She’salso only reading it half-asked and starts loudly asking about the suctioningover and over again. Well, it was last, after my reassessment, and only if itwas needed. She told me redo it only using the five skills. Since she had beenso hyper-focused on the suctioning, I assumed that maybe she wanted me to takeover for the respiratory therapist. So now that’s first on the list and theLasix IVP is 2^nd. It was wrong. She said that I missed the prioritywhich was the Lasix and that I have to come back and do another scenario. Itried to tell her that I had that the first time but she wouldn’t hear me out.Desperately wanting to get her back on my side, I fumble and fidget and lose myconcentration. I can’t find the tuberculin syringe to do my Heparin skill, so Igrab a 3 mL even though my med was less than 1 mL. Wrong. So I look again, andI still can’t see it. The only small one left is an insulin syringe. Wrong. Iknow this, but I also know that my instructor doesn’t have a high patiencetolerance. Long story short, I really blew it. I was still reeling from thescenario that she wouldn’t read. I came back the next day and everything wasperfect. I was not under the same amount of stress, which would explain myability to function normally.

I got an 80% on the final exam. Sheasked what was different about this test that contributed to my higher score. Itold her that I felt that the test questions were pretty clear, which was onlyhalf- true. After I got up and asked her my first question, I could sense thatshe was really irritated so I didn’t ask her my other two questions, which Iended up getting wrong. Even though I knew that I didn’t successfully pass the coursefor a second time and that it would result in my dismissal, I still wanted togo over the questions. I want to know what I’m doing wrong so that I can fixit. It’s true in every single course. I want to review every test so that I canget better. I would be concerned if the student didn’t want to review the test.A student who doesn’t want to know what they’re doing wrong obviously doesn’tcare enough to change. I think that it’s incredibly unfair for me to be treatedthat way for the pure and simple fact that I wanted to learn. I think that it’sstrange that I didn’t get my clinical evaluation until after the final. I alsothink that she had every intention of failing me for clinical if I had passedthe lecture portion. My clinical evaluation was terrible. She said ( or yelled,rather) that I was unsafe to administer Heparin (even though I had done it justfine in clinical), my care plans weren’t specific enough to my patient, my medrecall was terrible, and that a few weeks ago, my partner and I didn’t ask fora med reconciliation form. She said that it was HIPPA and that it was a patientsafety issue and that it was a big deal that we didn’t ask for it. I told herthat we assumed that there wasn’t one because it wasn’t in our stack of papers.The real question is, if it was such a huge patient safety issue, why didn’tshe say anything when it happened rather than wait until the last day of class?That was an issue 3 weeks ago and I had other patients after that. Was shegoing to let us keep making the same mistake over and over again?

Right after the heparin comment, I started to say, "You....". She then goes, "There you go... blaming others. You can't even take responsibility for your own mistakes". Had she listened to me, she would have known that I was just going to say that I was confused because she kept repeating "HIPPA" over and over again in the med room at clinical. It wasn't until a few minutes later that I realized that she was talking about my performance exam, which isn't really even fair because she went out of her way to intimidate me during my check-off.

I was allowed to look at my finaland ask questions about it. At question three, she yells, “I’m not going to sithere and argue with you about this. If you want to know because you want toknow than fine, but….” I’m not sure why she’s so defensive about the questions,but some of them are eerily familiar to the way she asks questions. She’sunwilling to accept that other instructors require different things in regardsto their process tools, and that some instructors even use their ownparameters. She’s made snarky, passive remarks about my ADHD that I haven’tdisclosed to her, which means either that she’s on the Reinstatement Committee,some faculty members may have some confidentiality issues, or both.Nonetheless, nothing she said hurt as much as when she told me that I needed tofind a new career, because I wasn’t good enough to be a nurse. I might not bean “A” student, but I bend over backwards to change something if need be.

I've never encountered a more cruel and calculating instructor as Shipley. Her reputation out in the community is fierce, but it's nothing compared to having a front row seat to watch the devil rip your heart out.

Next post: Word of the day: blame... and how I figured out that these assholes were working together....

Reinstatement? For me?

I cried the entire way home from my meeting with Joseph. I was angry, hurt, embarrassed, and ashamed. I obsessed over it for hours before I finally decided to email him (emails are copied and pasted directly from my school’s website).

Joseph, Thank you for meeting with me yesterday. After getting home yesterday, I started to wonder if I miscommunicated what I was trying to say. I was not trying to say that faculty members were wrong in determining test questions and answers. What I wanted to say was that as a student, it’s difficult to get a test question wrong and later be told that you were right or that the question was poorly written. What makes it even more difficult, is that when you’re taking it in the testing center, there is no one to ask if you have a question. By no means did I want to go in there and belittle your faculty.  That’s the last thing that I would even consider doing.  Please don’t feel that you have to respond to this email. I’m still trying to “recover” from yesterday’s conversation.  I simply wanted to apologize if I there were some things said by me that would give the impression that I’m playing the “blame game”.  I hope that you and your family have a nice holiday. Susan

Susan

 I appreciate the communication.  It would have been great to have that meeting with Prof. Molly Roll to clarify those test concerns.  Your clinical evaluation was positive and I would hope you will continue and graduate from the Nursing Program.   Is it a possibility that you just need more time with the content in Nsg. 222?   Enjoy your holidays.

Joseph, I can see how one may think that. I will admit to not knwing my meds how I should have for the first test. So in that aspect, yes. I believe that my biggest problem was answering test questions. I had no problem verbalizing or applying content. That being said, there were a few questions that I misread or didn't understand what the question was asking. Molly always told me that I rush through tests.  My response to her was that it didn't matter how long I looked at the question, I still wouldn't pick any of the answers exactly how they were written. I would always have a rationale, and sometimes they weren't right, but a lot of the time they were. She also said that I talked myself out of a lot of things. Maybe, maybe not. I just feel like sometimes there isn't enough information given to accurately answer the question. It doesn't mean that I don't know the information. I would do great if the tests were given verbally :) Susan

Joseph, I forgot to say why I don't want to meet with Molly. I don't want to experience the same stress response that I had during that five weeks again if the outcome isn't favorable. It's not because I'm unsure of my rationale, but rather that I don't want to bring personal feelings into the mix that will most likely be repeated to peers and that will ultimately end up hurting my credibility down the road. I understand that this program wants to promote confidentiality, but in my own personal experiences, people talk. It's human nature. Due to the fact that it was only Molly and I reviewing together after each test, it would be difficult for me to argue a point unless I was absolutely positive that others who practice in the field agree with my rationale. Therefore, it would be in my best interest to decline a meeting at this time. I don't have enough courage to stand up and speak out if everyone around me feels differently. I'm sorry that I didn't mention this earlier, but the tone of our meeting suggested that I keep that information to myself. It's always hard being the first person to speak up when they feel like they have been treated unfairly or were at a disadvantage. All I ask is that you please remember that I wouldn't have wasted my time if I didn't feel so strongly about it. It was very hard for me to come to you and say what was on my mind. As a nursing student, I take this program very seriously. I do understand that my past does hurt my credibility. That being being said, you can from my current grades that I strive to do as well as I can to meet Sinclair's standards. At the end of the day, I want to feel as if the time that my kids are away from me is well spent. I can imagine that any parent would feel the same way. Susan

No response from the last two emails. He was so persistent about Molly joining us during our meeting but I couldn’t find the words to explain how anxious I was around her.  My blood pressure was consistently twenty points higher than what it usually runs, my heart would race, and I had “the shakes” so often that other people noticed. It wasn’t that I didn’t like her necessarily, but I knew that if I had that response again coupled with the complete lack of tact and unwavering hatred for me, I would find the nearest hole I could find and crawl inside and never come out.

I had promised to call *D and *A and let them know how my meeting had gone. They were shocked as well, but their meetings had already been scheduled. I was eager to find out how their meetings went and I spoke to each one right after their meetings. Both reported that their meetings went great. He was attentive, took notes, asked questions… and not once were they subjected to Joseph’s critique of their transcripts. We all had a few academic blemishes, so why was I the only one to be put on the chopping block? I thought about the differences between our meetings for weeks. I eventually came to the conclusion that he was respectful towards them because they were in his age group, and that I’m just some 23-year-old who’s flapping her gums.

My frustration quickly turned into elation when I got the call for reinstatement. Even though I was put into Shipley’s section (she has a TERRIBLE reputation), I was happy just to be reinstated. The first person I called was *D. She was just as excited as I was until we started to talk about her reinstatement.  She quickly hung up with me and called the school. The reinstatement committee wasn’t scheduled to meet until a few days before the quarter started. *D and I talked about my stroke of luck for hours before coming to the conclusion that Joseph must have went back and looked at the questions  and saw that I was telling the truth. I felt so vindicated. It was short-lived, though.

Next post- She must need hearing aids because she sure as Hell isn’t listening to anything that I have to say

Five Weeks in Hell

NSG 222- My instructor was nice. She had incredibly high expectations, and we did our best to meet them. I actively participated in class. Although I could speak the content pretty good and could recite my meds fairly fluently during med recall, I was still failing the tests. It was incredibly frustrating. My instructor was very good about going over my tests with me. After the first test, I started to challenge the questions. In some cases I was just wrong, but in other cases my instructor would tell me that she thought that they threw this question out or that question out. Other times it would take her six times to read the question and try to figure out what it was asking, the same number of times that it took me. A few times she even told me that I was right, but the answer that I had chosen wasn’t the one that they were looking for. I asked her if they could keep the scrap paper that we get in the testing center to write down rationale if we have any problems. She told me that they couldn’t do that. I was really frustrated. I felt hopeless. My demeanor completely changed. I honestly felt that I had a handle on the content and that the questions were too vague. Our entire class looked as if they had been to war. Everyone was struggling.  Many of us went back to school after clinical to learn EKGs because we didn't feel that we knew them well enough to be tested on. J* was a lab faculty member and she is the only reason that we knew EKGs at all. Not only did she teach us EKGs, she would also talk about the content with us. On one day we were in the lab discussing the content that we were about to be tested on when another NSG 222 told us that what we had learned was wrong. We told her that Molly said that what we were saying was right, and she said, "Well, you can tell Molly that what I said is right and she can call me about it if she has any problems with it".We all had power points from another instructor and used those as well.  There were some discrepancies, which unfortunately contributed to some missed questions. I can’t argue another instructor’s notes. Even though I think it would be terribly disrespectful to do so, it was still unsettling that there were so many discrepancies, considering that all the students were given the same test questions. I did good on my EKG test, earning 9.5 out of 10 points. I did have to take my math test a second time. For check-offs, I had to redo my IV push and scenario. The only test that I did pass was the final, which I only got an 85% on. My instructor’s biggest issue with me was my process tool (care plan). I did try very hard to navigate Epic (the hospital's charting/ communication system) and find all of my information. Epic was new to me (I had never been to a clinical site that used it and neither does my work) and we didn’t have a lot of time to find things, so I did have missing data. She also had issues with my plan of care. At the Atrium, patients don’t stay for very long and my patients were always scheduled to leave that day or the next. With that in mind, my interventions were only those that reflected their current state of health, not their admitting diagnosis. Once I figured out that my instructor wanted a plan of care based on the disease and not the patient, she was much happier and told me that she was very impressed with my care plan and the improvement that I had made. Had I known that earlier, I would have done just that. In regards to my missing data, I refuse to make something up just to fill in the blank. I’ve been advised by other students to do so and that the instructors didn’t know the difference, but for me it comes down to integrity. I don’t want to get in the habit of thinking that it’s okay to make up stuff I don’t know. I don’t think that it’s a quality that a good nurse possesses.  
My instructor was aware that I had ADHD. In the beginning of the quarter, I had told her that I was having trouble getting my prescription filled due to a drug shortage, which was true, but mostly an attempt to hide my true feelings towards the test questions. She was very understanding and seemed like she cared a lot. I did everything that I possibly could, but I still ended up failing the course by about 7 or 8 points. I felt like I was not only a failure as student, but a failure as a mom as well. My kids spent many nights away from home for nothing. It truly broke my heart. My only saving grace was knowing that I wasn’t the only one having issues. Students who usually earned A's were struggling to get a B, and some were even struggling to maintain a C. Two, possibly three other students failed in a class of nine. This is NOT typical for students who are so close to graduating. Not to mention, NSG 222 has an incredibly HIGH failure rate (more on that later), which I was not aware of at the time. Once the grades were posted, it was official: I was holding my family back once again. In talking with my peers afterwards, I and two other students thought that it would be a good idea to talk to someone about NSG 222. It definitely turned out NOT to be helping hand that I was looking for.

Next post: Meeting with Dr. Jekyll/ Mr. Hyde