Worms

I'm in the thick of school although I haven't written any papers yet. I've had two tests in Pharmacology and get this, here's my grades: 74 and a 90. Quite a disparity, huh? And he was trying to convince us to take the class for a grade instead of pass/fail. Um, not me, fella. It's one of those classes where I listen to his lectures as I drive. And write things on index cards to memorize as I stand in line. Every available brain cell called to action, every available speck of attention.

Clinical is so much fun. If ever I waver about doing graduate school, clinical always reassures me that I'm in the right place and that I can do this. I look forward to it so much. I mean, what's more interesting than people with problems? And you know what, as a nurse practitioner, I'm in a privileged position to walk thru that door to someone's inner life. That will be especially true as I focus my clinicals in psychiatric work next year, but boy, it's already happening as I work with FNPs.

Here's some examples. I had weird worm week. First, I worked at my RN job at a private psych hospital for the day and had an interesting patient experience. A young man called me into his bathroom to check out his feces. Something I've done before, no big deal, usually it's blood. Ah, but this is a psych hospital, right? First he says, better bring your gloves. I say, well, I can go back and get them if needed. I'm thinking it'll have to be something damn special for that, like a little alien fetus. But anyway, I take a look and it's pretty ordinary. He says, a hysterical edge to his voice, "See it?! See it?!". Uh oh. I say as calmly as I can, tell me what you see. He says, "It's worms, see them, see them?" There are no worms there. "You can't see them? Look, look, see the wiggling!" and with that, he reaches into the bowl and starts moving things around with his hands. I think I jumped back a foot.

The next day, I'm at one of my clinical sites and a young woman is there, fearing she got worms from her new puppy. Since I'm the newbie, before we see her, it's my job to do a little research. Can humans catch worms from dogs? Yes, they can. We saw her & collected a sample. It sounded positive to me, based on her description. Be careful with new dogs, especially strays & puppies. The following day, I'm at my other clinical site, a family practice office, and a middle-aged woman comes in and says that she is certain she has worms. She's seen them, wriggling. Has no idea how she contracted them. Catch another sample. Now, what are the odds of that? I really doubt if lots of folks walking out there have worms. Just my luck to encounter three of them.

It's going to take some adjustment for me to get used to dealing with college students as patients. A young woman came in for a chronic cough that we diagnosed as sinusitis, but during the assessment we asked her about everything (as we always do), and one question was how much alcohol do you drink. Notice we don't say do you drink. She says, Oh not very much. So Sheryl, my preceptor, says, how many days a week? "Every Friday and Saturday. Sometimes Thursdays." And then, how much? "Oh, four drinks....well, five. (A beat passes) ...at least." Sheryl just writes it down, says nothing. I feel like my hair's on fire. At least 5 drinks 2 or 3 nights a week?! She's only 5'2" and weighs 110 lbs. That must make her drunk as a skunk. When Ken & I go out to Vino Vino (one of my favorite places), we always order only 3 glasses between us. I usually drink about 2 of them, and I feel good. I mean, I'm in no shape to drive. How does she do that? But I'm thinking Sheryl hears that often. I better adjust my attitude. And well, it's the psych nurse in me.....I want to talk about it with this girl. But certainly that's not on her agenda. She's made it clear she just wants a z-pak. Patients are seen every 20 minutes so we're out of time anyway. Another thing is that I'm only there 4 hours a week, but Sheryl has already told me that we'll see at least one STI (sexually transmitted infection) every time.

I've been thinking about clinicals a lot lately, because they are taking up so much of my time. 120 hours this semester, and I'll actually get even more. That's just a minimum. Right now, I spend 4 hours a week at the student health center, and 6 hours at a family practice office. After spring break, I'll add 4 hours at a pediatric community clinic to that. That's 14 hours a week on top of my full-time school.
And next year those hours double. I've been told that you pretty much have to work on them on weekends or you just can't keep up. But I learn so much. I was thinking about when I first got my business degree at UT, there was absolutely no "clinical" to that at all -- just here's your degree, you've never worked an hour in this field, go out and be a professional. It was ludicrous. Let me tell you, I was quite clueless at my first job as an internal auditor. And I was a good student. I think healthcare really has this right -- some other fields are doing similar things. My sister got an electrical engineering degree from UT about 10 years ago and she had to do some internships (externships?) for her degree. In nursing and medicine, clinicals are so important because people's lives are in our hands. That's true, guess I couldn't kill someone with a spreadsheet. But it also so well prepares you for the workforce, I don't think other disciplines get that.