Thursday, August 11, 2005

Fecal Elimination

90 year old lady calls us because her blood pressuure machine reads 160/90 and she thinks that is too high. I have her call her doctor, who tells her to come to his office instead.


A woman falls at the bottom of the stairs, hears a crack in her ankle. She gets 10 of morphine and a pillow splint before we even move her. She has a comfortable ride to the hospital.


Another 90 year old lady tells her visiting nurse her heart feels irregular. We brought her to the hospital for the same thing several weeks ago. She wore a halter monitor that showed she has tachy-brady syndrome. The nurse is concerned that her blood pressure is only 90/60. I listen to it, very slowly. I get 140/90. You listen too quickly to an irregular rate and you will get a false reading. She goes back to the same hospital. She is in no distress.


It looks like one of our medics out here will be leaving in December. He works Sunday, Monday, Tuesday. While I have seniority over him, out here once you are in a shift, you are in a shift. Since I used to play softball every Sunday in the Summer, I chose to work the Thursday, Friday, Saturday shift, and have twice declined the beginning of the week shift. The problem with the end of the week shift is I have no weekend. I have to be at work Saturday morning at six so no late Friday nights, and my Saturday shift ends at ten, so I am too tired to go out, particuarly if I can boned with a late call. I'm looking forward to shifting.


Just finished studying "Fecal Elimination." About a year and a half ago, I was bored and heard about this program where a paramedic could get a nursing degree by taking exams. While I had no real desire to be a nurse, I thought it might be a good education and a good insurance policy in the event I hurt myself or overtime dried up. I banged out five courses in five months -- Gerentology, Life Span Development, Anatomy and Physiology, MicroBiology and Nursing 1 with three As and 2 Bs. I took the tests in a nearby town on a computer. They took less than 2 hours and I got my grade each time before leaving. I was all set to take Nursing 2 when I realized while I could probably pass the test, I really hadn't studied and what was the point in taking the course if I wasn't intent on learning.

Anyway, since I had already registered to take the exam, I had a year to take it, and my year ends in September and I have been too busy to pick up a book in that time, so today I picked up the book. I'm taking the test next Tuesday before work.

Here's what's on it: Nutrition, Elimination, Oxygenation, Fluid and Electrolyte Balance, Activity and Mobility, and Rest and Sleep.

Today I learned about enemas and colostomies.

After I take Nursing 2, I have to pay $800 if I want to enroll in the program. You have to be enrolled to take Nursing 3-7. Each test cost about $200. After completing those courses, you do a two day clinical, where you show them you can do IVs, foleys, put pills in paper cups, and then you have to take care of three patients, writing a nursing plan, and making certain you wash your hands all the time, while a grey faced nurse with a pointy hat makes notations on a clipboard. The practical only has a 60% pass rate and costs $1500 to take. I wouldn't want to fail that. I do much better on the writen than practicals.

Assuming you pass everything the first time(and depending on the prerequisites you need), the whole cost for me is about $6000 for the degree. It is good in 48 states.

The place is called Excelsior College.

Excelsior College

I'm not planning on enrolling for awhile -- not until I'm ready to bang out the rest of the courses, which could be awhile. I love being a paramedic, the overtime is unlimited, and I've got too many other things keeping me busy.

Tonight I study Urinary Elimination.