Significant

I have graduated. It was a pretty decent day, not too hot and had that nice milestone feeling. I thought the speakers were thoughtful and (most important) not too long. This was just for the school of nursing so it was pretty specific, and I liked that. I must say, I was quite glad that I did not wear heels. Lots of walking, traffic was super awful. Apparently different schools had their convocation ceremonies at the Bass Concert Hall all day long, separated by 2 hours, so as people were leaving, we were arriving. I saw all my Psych NP classmates (all 9 of us).

I have to say, this would not have been possible without the support of my husband, Ken. It was quite a luxury to only work on the breaks (& even then, only because I wanted to). This was a successful joint project. I'm finally at the point of doing my life's work. BTW, here's a link to a story that eloquently explains why I feel that way. I want to be the one that makes a difference in someone's life in exactly this way. Modern Love Story

After graduation, Ken and I went to Kerbey Lane (yep, the original one). I've been going there since 1980, when I first came to UT. Yep, 33 years. Feels incredible. There was a loud table of young ones next to us with a few fellow graduates, drinking mimosas. Great way to spend a Texas afternoon. BTW, I just have to mention that I'm wearing two nursing pins on my gown, nurses go through this unique "pinning" ceremony when they first become nurses, one of them is my grandmother May's pin, who was a nurse in Arizona in the 1930's, the first surgical nurse in a small Arizona mining town. A pioneer. The second one is from my original graduation from Our Lady of the Lake College in Baton Rouge, in 2007. Another meaningful day. 

Then we flew to New York to go get our daughter. We had some fun, but it was a super quick trip (only there 4 days). We went to MOMA, wandered around Soho, and saw a Broadway show (Kinky Boots - fantastic, makes me want to be a drag queen for Halloween next year, ha!), and got her and her stuff back to Texas. We had six heavy suitcases and shipped two big boxes of clothes, but we did it. I ate the best Thai food I've ever had at a place called Peep in Soho, and of course, we had to try the vegan falafel sandwiches that Dani has been living on at Taim (it was as good as she said).

Here's some pics from what we did.

So now I'm just waiting for the authorization to take my boards, and I hope that will be soon although I haven't started studying yet. Not sweating it too much. 

This is an interesting time to be entering this profession. The DSM 5 just came out and is pretty controversial. I listened to an interview on NPR a few days ago with the new head of the American Psychiatric Assn. and I thought he explained/defended the viewpoint of the mental health professional community pretty well. NPR DSM-5  People are upset because we have much more detail in this volume - the first new edition since 1990, which is an eternity in science - but many people don't feel that upset about the fact that similar guidelines for physical diseases, such as heart disease, diabetes, etc. have had even more growth in their body of knowledge. We know more, shouldn't we inform more? And no, I don't agree that we are pathologizing normal (which seems to be the main criticism), it's still an individual clinician that is licensed to make an actual diagnosis - no just anyone can do that - and one of the most important things that the DSM stresses over and over is that if you have a mental disorder it should cause you significant distress and impairment in your daily functioning. If those two criteria aren't met, that it should call the diagnosis into question. 

Next up on the agenda: buy our son a car this weekend, and get each teenager a job. No small feat. Hopefully I'll have job news myself in the next post. I talked to the director of Shoal Creek and I've essentially crossed that off my list because they don't anticipate a start date until September. That tells me they really aren't interested in new grads. I'm certainly not going to wait that long.

Perched on the Handlebars

I took my last final exam this morning. As in "last in my whole entire life", unless I'm going to enter a new profession again. Which I guess is not too unreasonable, given that I've already done at least 5 different things. Those would be (in order): accountant/auditor, systems analyst (which includes many different types of jobs, from project leader to software developer), group exercise instructor, RN, and now....Nurse Practitioner. Yes, I know, I still have a pesky little thing called Boards to pass. NBD. I'll take it soon, but not before May 25th -- that's when UT will officially send my degree info to the credentialing organization.

It was the Pecan Street Festival last weekend, and it was perfect weather. It's been such a cool Spring here, makes it more pleasant to be outside. But of course, there's the grumbling I do as I run to my car in my sweat-soaked clothes before it's even light in the morning. Not digging the cool weather then. But that time appears to be over. Anyway, Pecan St. was a real shopping opportunity, which I did not waste. And half the fun of anything in Austin is the people watching. Great city for that!

I'm still figuring out where I'd like to work. Yes, to quote the Shins, it's like I'm perched on the handlebars of a blind man's bike. I am pretty sure that I'm going to work for a psychiatrist in central Austin in private practice. But I did get a call from a large local psychiatric hospital last week, and they are seem very interested because I have a variety of psych hospital experiences, both here and in NJ. There would be advantages to working there, but the biggest downside is the traffic. I would certainly have to be there for morning rounds - probably at 8:00 - and the traffic would be a nightmare. If I didn't want to be late, I'd need to leave an hour before. The advantage would be higher initial pay, full benefits, but mostly the variety of patients (including those serious mentally ill, which I love but won't see in this practice) and working collaboratively with a large team that includes psychiatric residents. And I'd be their first Psych NP, so it would be ground-breaking. But working in private practice, I can shift my work hours -- arrive at 9:00 or even 9:30 -- and voila, no traffic. Yes, the flexibility would be divine. I have spent 2 days with the Doctor and his existing two NP's and I like/respect all three of them - it feels like a good fit. And this morning, I got an email from his office manager basically asking if I was ready to start job negotiation. Still thinking about checking out the hospital.....urggg, but that traffic.....of course, that's only for two years. When Nile graduates, Ken and I plan to move closer in.

Anyway, that's all been on my mind. Here's something funny. Antipsychotic medication (things like Thorazine, Haldol, Risperdal, Zyprexa) are being found useful for more and more things. They work as mood stabilizers for bipolar disorder and work as an augmentation agent for treatment-resistant depression. But when you say the word "antipsychotic" to a patient, they just hear PSYCHOTIC and flip out. What? I'm not taking that drug! So my clever professor advised us to call them.....broad-spectrum psychotropic medication. Isn't that great? You also see that when you tell a bipolar patient their diagnosis - they envision the Hollywood mania and get pretty upset - WHAT? I'm not manically crazy! I haven't spent every penny and had sex with every man on the street!

I have an Ebel Beluga watch that I bought a couple of years ago on Overstock.com. I saved a few hundred dollars on it and figured that was great. The bracelet broke and I took it to be repaired, which the jeweler said that they could not do. All repairs have to be done by authorized Ebel jewelers or I can ship it to Ebel. I went online to get a repair order and ship it....and guess what...it's counterfeit. The serial number is invalid; it's not even the correct number of digits and letters. Now what? So I googled around and found someone that offers to repair any watch -- I sent it to them. But here's the fun part of this story. I dreamed that night about my watch, that I opened it up to see the inner workings and then I ate them. Yep, crunched up all those little delicate metal pieces. Yum. (note to you: don't buy luxury items from that web site)

Graduation is on the 17th. I'm excited but it will basically be a hellish day. Because of the Boston bombings, security will be super-tight and everything will take longer. Graduates cannot bring any bags or purses. Guess I'll stick my lip gloss in my bra. Spectators have been advised to only bring a bag/purse 12" or smaller, and warned that lines for those to be searched will be long. Better to just go through the metal detector and carry nothing. Oh boy. 

I had an interesting conversation with my hairdresser this week. It was the day that they discovered those three women held captive for 10 years. She wanted advice on whether to bring it up with her two young daughters. We talked about the risk of scaring them unnecessarily vs. letting them hear about it on the news, and talked about the relative risks of stranger danger vs. someone a kid knows (stranger is actually quite rare, most common is parents stealing kids in a bad divorce, but behind that is relative/acquaintance). And we talked about the nature of evil, which is the only thing I can call this. I'm an atheist, so I have no biblical beliefs about the devil and what caused such a thing. Is he mentally ill? Well, of course, it would actually be fascinating to do a psychiatric evaluation of him (if he would talk, surely his lawyer is putting the kibosh on that). Deep down in my bones, I know this man is just plain evil. Very few mentally ill people are violent or motivated to do something like this. And here's the thing - you can't really tell. When I worked at a state psychiatric facility in NJ, we had some of what you call "forensic" patients and a few of them had done absolutely terrible things. I can still remember that one of my patients needed to go off-site for some specialized medical test, and in big red letters inside his chart it said "must be accompanied by two mental health officers for any off-grounds appointments". I had seen orders to have one officer, but two? Then I read further in the chart that he had been a serial rapist. Great. (Rule on the first day: never let the patient get between you and the door.) But was there any clue when seeing this patient in the milieu with everyone else? Absolutely not. Just another guy. 

One more pic. These are my fellow UT Psychiatric Nurse Practitioner graduates, professor (far L) and program director (far R) for 2013. We are a small group, there are many more Family NPs and also about six Pediatric NPs.