Logical, Consistant withTrade-offs Explicated: Let the Comps Begin

Well, if anyone is still looking at this blog occasionally -- think good thoughts for me over the next 48 hours. I just received my two (one qualitative, one quantitative) comprehensive exam questions. I have 48 hours and 32 to 40 pages (16-20 pages per question, double spaced, no smaller than Arial 11 font, one inch margins) to prove I know enough about research and research design to do my own work. I just received the questions. I think they're doable...

If I start going crazy, I might just come back over here for a breather.

School's Out!

Good intentions and all that, I still don't seem to have gotten the hang of this regular blogging thing. But schools out, and I'm done with coursework! Well, almost--I have planned to take one more teaching course in the fall.

But my core coursework is done...all I have ahead of me, before I can officially start on the dissertation phase is...(cue Jaws music)...Comprehensive exams. What is that you're asking? Just an opportunity to show that I've absorbed and synthesized everything I’ve been taught in the past two years. We’ll be getting two questions on Monday, July 23, and will have 48 hours (and a page limit) within which to respond.

In the mean time, my cohort as been attempting to review all of our core coursework, but we have not done as well as we had hoped in terms of formal review. We do have a 4 day ocean-retreat planned for a couple of weeks from now, but I’m still nervous. (And frankly, tired of all the people saying “you’ll do fine,” I think that creates as much anxiety as it attempts to dissipate!)

The up side of all this is that, for a little while at least, my schedule is somewhat opened up for the first time in ages. Yes, I have that studying hanging over me, but no formal writing or reading to do, and I’m only working three days a week….which is two days more than I have been working.

So hopefully, I’ll have more things happening worth posting about (I have a recent experience which I need to get on paper soon), and more time and energy to actually post, not just think about posting.

I’d say “watch this space,” but I don’t want to set myself up.

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And in different news, I’ve been accepted into the Palliative Care Fellowship at the VA. I’m not sure exactly when it will start, probably in September or October. It’s for nine months, and I’m really, really looking forward to this experience.

Confusion

He has heart failure, diabetes, and dementia.

She has multiple morbidities of her own. She has a history of abandonment (not picking him up after a respite stay – staff finally drive him home).

He has no short term memory (but he “can remember back to when he was in diapers”) and makes multiple calls home. Sometimes he’s accusatory, sometimes he just sounds desperate. Sometimes all he wants to do is say “I love you.”

She can’t take it anymore. Now, he gets one or two calls a day.

He is on hospice, but he’s not really that close to dying (damn those uncertain trajectories!)

Sometimes he thinks she’s dead. Sometimes he thinks (rightly so?) that she’s abandoned him. “After 67 years, I’ll never see her again.”

He was on a high dose of pych meds for his "behavior" at home. He's been being weaned down.

Sometimes he gets angry, sometimes he just sobs.

But give him some attention: a back rub, some comforting words a milkshake made specially for him, and often you can distract him from his pains, physical and mental.

At least for a while.

Procrastination, Conciseness and Celebration

Well I started this blog with great intentions and somehow it got lost in the usual slog of procrastination and coursework.

At this point, I have several partly written pieces that I just haven’t gotten back to. Part of my problem, I realize is that I have a hard time writing short, pithy pieces—succinct has never been my middle name (is that why I have such a hard time spelling it? Thank the goddess for spell-check).

But learning to write tighter and shorter is not only an admirable, but a necessary goal. An F31 (NIH predoctoral training grant) is limited to 10 pages. I think an R03 gives you 20. Many journals have page and/or word limits. And my Hartford application was limited to a 2-page letter and a 3-5 five page “professional development plan.”

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Which brings me to the third word in my title.

The John A. Hartford foundation through the Hartford Geriatric Nursing Initiative supports the Building Academic Geriatric Nursing Capacity (BAGNC) program, which has, among other things, the BAGNC Predoctoral Scholarship (are you still with me?). If you go to the site, you’ll see that this scholarship is very generous. And very competitive – check out who is on the advisory committee here and the selection committee here. I mean, the directors of NINR, NIA, AACN and GSA? (among others). You don’t get much bigger in terms of Names in Nursing.

So, last year, I applied. And didn’t get funded. This year I applied. And got selected! I am so stoked, amazed, honored, thrilled….you get the idea. The timing is also perfect. Next quarter is my last quarter of coursework. The funding, which will start after this school year, is for two years. That means I have two years to work on my dissertation without financial worries. It also means I have Very Good Incentive to finish in two years.

So, hopefully (if anyone is still with me after my long silence) you’ll be willing to raise a glass with me in celebration.

What’s with the title?

One of the reasons it took me so long to start a blog (beyond my usual ability to procrastinate like no one’s business) is that I was having a hard time coming up with a name. I didn’t want it to be too cutesy, but I also didn’t want it to be too boring, and I wanted it to say something about who I am and what is important to me. I wanted something that made the nursing and hospice connection.

So, an explanation: Dame Cicely Saunders is commonly considered the “mother of modern hospice.” She has a long and fascinating history, more of which you can read about in many places including here. One of the seminal stories about Saunders his how she was inspired to start a hospice after meeting a survivor of the Warsaw Ghetto David Tasma, who she cared for as he was dying of cancer, in loneliness and anguish. He bequeathed her 500 pounds and said he’d “be a window in your home.” Her conversations with him, and her determination to relieve his pain – not just physical but emotional and psychic was the impetus to her working to create the modern hospice movement.

So I liked the story, and it make a title that was both apt and a bit cryptic. But more than that, I think it reflects one of the most amazing parts of what it means to be with people when they are dying—it is such an intimate time, such an honor to be allowed into someone’s life. And ultimately, the gifts you get from being a witness to this last chapter of their life is beyond measure.

Hello World!

Well, probably at this point there is no “world” out there for me, as I have no readers. I am not yet sure who, if anyone in my personal/professional/academic life I will let know about this little project— My plan is to remain anonymous and use a pseudonym (although if any of my friends do find me, they’ll know who I am, as I’ve been using the name for quite a while now).

So, where to start: perhaps with why I decided to have a blog. I’ve been toying with the idea on and off for several years now, but always found myself too overwhelmed with other things—and other ways of procrastinating. I think the tipping point (besides finally coming up with a name I liked) was the realization that there are times that my responses on other people’s blogs are so long that I might as well be writing my own! Of course, since then I have posted at least one more long response and still haven’t gotten this one started. I think I’ll just crib my post and make that my second post here (stay tuned!)

So why have I been thinking about blogging? I think for the same reason that many do—I think there are things that happen in my life and in the world around me that I want to comment on and share. I have become an avid reader of nursing blogs, and as well as blogs feminist, political, academic and few miscellaneous (Blog roll to be completed as soon as I can). I realize that I have stories that others may find interesting or entertaining, and, as final justification, I realize that this can be a form of self-reflection, which, as both a health-care provider and a student are Good Things to Do. I will also confess that Kim over at Emergiblog has been an influence—she is such a cheerleader for people to pick up the habit, and she finally got me to take the bait. We may have different politics and, at times perspectives but I admire her energy enthusiasm, passion, and writing.

Oh, one other reason to do this: one of the fine arts of grad school is devising wonderful ways to procrastinate doing all the things you Really Should Be Doing. This seemed like a quite elegant time sink.

OK, so that’s a bit about Why, now, perhaps a bit about Who.

For starters, I am an RN. More specifically I am a hospice nurse. I am also a middle-aged woman, who has only been a nurse for the past 3 years. Clearly, this is not my first career. I have, in the past and among other things, been a Sign Language Interpreter (specializing in health care interpreting), a conference planner (for a company that made OR scheduling software, and an office manger for, among other places, a complimentary health clinic. It seems I circled this field of health for a long time. Sometimes I wish I’d figured out what I really love sooner, but ah well that’s life.

As I say in my profile, I work for a Large Federal Health System in the U.S. Where I live there is the acute hospital, the clinics, and the long-term care (LTC) facility. The LTC is where I work. It has three units: a skilled care unit, a rehab unit, and a hospice/palliative care unit. My heart is in the hospice/palliative care unit, but, because I work such sporadic hours because of school, I am often over in the skilled care side. I love our patients—mostly men, many with a wide plethora of chronic illnesses as well as mental health and substance issues. Comes with the territory. War, and it’s aftermath is truly hell. I will likely tell stories about work (including why I became a hospice nurse) as time moves on, but I can’t include everything in this first post, now can I?

I am also a doctoral student with a focus on family caregivers of persons at end of life (EOL). At this time, it looks like my dissertation will be a follow-up study of one that I have been a research assistant on, looking at hospice care in Assisted Living Facilities. (ALFs). I will finish my course work in June, and then take my comprehensive exam, and, providing I successfully pass it, start working on my dissertation.

These two topics (work and school) occupy most of my time and energy, and will probably be the source of much of my posts, however I must add that I also have a lovely partner, S. also known as The Basement Troll, as she spends most of her time in her office in the basement. We have another person living with us, an old, dear friend, Ms. Evil Boots, also known in the blogosphere as Magpie. Then there are the 5 cats – only two are mine, but they all run the house pretty much.

So, that’s more than enough of an intro. I am not known for being succinct, so it’s not surprising I’ve gone on for so long. Hopefully not too boring. Stay tuned for more engaging material down the road.