Why Judge My Book By My Cover

Here is a link to my blog at the White House  http://www.whitehouse.gov/champions/blog?page=1

 You can also read it below. It was an amazing experience. I will blog soon about the other Award winners and amazing Women Veterans I met last week.

I was a U.S. Army Nurse Corps officer and trauma nurse. I loved and valued the times I was able to care for seriously wounded soldiers, and remember vividly the lives my team and I saved in Afghanistan. I also conducted presence patrols in and around the city of Ghazni, Afghanistan. Situated on a plateau in the central region of Afghanistan, Ghazni has a population of about 140,000 people and a long history of military invasions.

On one patrol, I was the figure of intrigue. A small tribe of local school girls approached me and giggled as I patrolled the area. Their eyes ranged in color from deep blue to light green and seemed large, hidden behind their head scarfs. They were fascinated by my appearance. I was female. My brown hair was tucked and braided under my kevlar helmet. I wore boots and had two weapons. Although I was able to smile at them briefly, I knew that my job was to help my fellow soldiers and scan for potential threats while patrolling the province.

With the interpreter at my side, the girls followed us for hours asking questions such as what my patch meant, had I gone to school, for how long, was I married, did I have children? I was probably an odd spectacle in their life. Yet I hoped with every answer I gave, that they too would be encouraged to go to college, become women leaders, and maybe even be nurses.

When I left the Army and transitioned to my new life as a veteran, I took those experiences and promised myself that I would continue to pursue my personal tradition of service in my community. I became a board member, then vice chair, of Cuidando los Ninos (CLNKids.org). CLNkids is a non-profit dedicated to address the needs of homeless families and ending childhood homelessness in Albuquerque, New Mexico. I work with legislators and local community members to educate them on homelessness and its far reaching effects in the community to include health and educational disparities, the rise of violence and PTSD, and how to work together as a community to end homelessness.

In addition, I am currently the vice executive director of the national organization American Women Veterans. The core mission of American Women Veterans is advocacy on behalf of military women, veterans and their families. Through speaking engagements and interviews with various groups, I explain the role of military women, as well as advocating for veteran issues such as PTSD and women in combat on a national and state level.

I enjoy the mentorship that comes with working with this organization. Through this advocacy work, I am able to connect with other service women, including amazing women like Genevieve Chase, our executive director. Genevieve is full of thoughtful ideas, challenges, and goals, such as how to build our board of directors or how to become more involved with advocacy at various leadership conferences around the nation. These suggestions sometimes overwhelm me and at other times inspire me to accomplish more, such as when I helped with the New York City Veterans Day parade.

In November of 2012, I helped coordinate American Women Veterans participation in the New York City Veterans Day parade. I gathered over twenty women veterans from various cities across the country. Throughout the day we marched, passed out fliers, stickers, and mementos, and were greeted along the streets of New York by other women veterans lost in the crowd of smiling faces, searching for a glimpse of recognition that they too served in the military side-by-side with our brothers at arms.

Often women veterans go unrecognized in the general public. While male veterans often wear hats proclaiming their service, women have no badge or insignia to signify their service, but instead work to find a balance between career and home life, while finding a new identity as a veteran and civilian. At times their transition can be lonely.

Most women are not recognized as serving in the military, let alone serving in combat. This can also cause delays in treatment when going to the Veterans Administration. I once experienced the frustration of overhearing an older male at the VA hospital while waiting for a dental exam. He said, “look at this young girl, probably here for her free teeth cleaning after doing her four years.” I was angry initially: who was this man to judge me? I am a veteran just like him, having served in multiple deployments. Why judge my book by my cover?

During the Veterans Day Parade, I was able to chat with Vickie, a fellow American Women Veterans member and United States Navy Veteran. Vickie is very involved in her community and is one of the first women I ever met at American Women Veterans. Whenever I see her, she calls me “little one,” like an older sister would. She continues to volunteer in and around NYC and at the VA in Bay Bridge. She works in counseling and understands, as I do, the challenges women veterans encounter. She wears a US NAVY ball cap to events we attend together and I can tell that, in her own way, she tells the world “I am a veteran.” She continues to remind me why I work so hard to advocate for change.

If Genevieve, Vickie, and I do not speak out for women veterans, I sometimes wonder who will. They, as well as other mentors in my life, serve as my personal motivation to keep working and striving, and to be that voice and advocate for change. All in a day’s work for this veteran.

I passed my ANCC Board Exam

Well today has been an exciting day! I promised myself as soon as I finished I would write a blog for all of the other Family Nurse Practitioners (FNP) in the world who have finished school and are prepping for their board exam. 

What’s on the test?

Well, I can’t tell you questions, and even if I did it would give you false hope that you would learn that one question and get that correct one out of 175 questions. You are smarter than that you don’t need that. But ANCC does give you a generic list of subjects, and the test is a mix of every single thing listed.

How did you study?

I made a plan. I work as an Emergency Room nurse so working and studying is hard to do, but I tried to make a plan and stuck to it.  I Bought three study guides: 
1. The Fitzgerald CD review Course 2011
 2.  Nurse Practitioner Certification Examination and Practice Preparation, 3rd Edition By Margret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC 
3.  Adult and Family Nurse Practitioner Certification Examination: Review Questions and Strategies, 3rd Edition By Jill E. Winland-Brown, EdD, MSN, FNP.

1.       I listened to the review course CD’s after graduation when I had spear time: at the gym, while in the shower, on road trips, etc.

2.       I took my down time (ha ha ha) and did the free on-line tests while at work.

3.       I gave myself one full month and set a test date. I told my family, my friends and Mountain Man that I needed this time to myself to study and that I loved them for supporting me in advance.

4.       In that month (when not working) I took it one section at time. I listened to the Fitzgerald CD’s, referenced my ANCC Yellow/Black book (my friend gave me) and my Physical Exam/Bates book as needed to refresh the brain. Then I would do the practice questions for that subject/section from both books. First Fitzgerald’s book, she has questions and answers with long rationales and I thought of it as a further refresher. Then I would take one of the 100-120 question tests from the Winland-Brown book. Here is another suggestion: I googled a free bubble test worksheet and made copies so I didn’t have to look back and forth and could treat it like a test. I kept a spiral notebook and wrote out why I answered a question wrong, what I needed to know, etc.  For example if it was a prostate questions, I read the rational and wrote down the evidence based guidelines.  One section a day, then that night, I would review later once again. Only one section a day. Then repeat.

5.       The week before the test, I listened the CD’s daily. Wrote out information that I wasn’t remembering so well (Anemia it’s my Achilles heel, etc.) a dry erase pen on mirrors in my bathroom and in my guest room. Then I could review, even while brushing my teeth.

6.       Four days before I re-did the free questions from ANCC, the last two review tests in the Winland-Brown book, the questions at the back of ANCC’s black and yellow book and the questions you could purchase on line. (A little overboard yes). All the while I scanned the review spiral I made and the Fitzgerald workbook that accompanied the CD’s.

7.       The day before the exam, I reviewed my notes again. Then I took a break and got a facial and some spa time. I needed to relax. I also drove to the testing center to make sure I knew where it was. Then I went out to dinner with Mountain Man.

8.       The night before the exam I took a warm shower, used my lavender lotion, took a melatonin and went to sleep.

9.      The  Morning of the exam I ate a good breakfast, spoke to Mt Man about the random things I was having trouble with (Rubella, Rubeola, what happened, when, for who, and how many pennies?). He thought I was speaking a foreign language and that’s okay.

1.   Arrived early and took the test.

How was the test? 

Long, short, and basically a roller-coaster. Some questions I knew, so easy that I re-read them twice to make sure it wasn’t a joke. Others I was absolutely in the middle of the road. I marked the ones I spent longer than a minute on and decided to revisit them. There were times I felt over prepared, other times felt like I should have covered more of that theory stuff. The therapeutic communication and NP role questions easy, the Veracity, Transference, counter transference were a little more difficult.

I took a break at about hour and half, went to the bathroom stretched and then went back in. I went over all the questions I marked. Some I changed, most I didn’t. Then I sat back took a breath and pushed end.

And I passed. 

 Fitzgerald has a free power point on her website about advocacy, legal and ethical issues (and the info is also in her CD’s) valuable information. Don’t skip over that.

Some things to mention:

 I had a few sleepless nights and I read about people not passing. At one point I almost bought another study guide. To be honest, don’t do it, you don’t need to. I also read one great blog and she said what I am saying YOU WILL PASS.  I felt as though there needed to be more positive blogs so that’s why I’m writing today. The study course I took from Fitzgerald was great, stick to that.  Don’t read negative things and make sure to take care of yourself.  Spend time each day to review a section and review what you don’t know. You are smart. You finished your  FNP, took tests, wrote papers, even did hours upon hours off free work (Clinicals right?) and now you take one test. Prepare before hand, and tell you friends and family you’re a hermit till this hurdle is over and they will understand.

By the way: I PASSED and SO WILL YOU!

Small Rural World

Day two of my clinical rotation in “rural” New Mexico. My drive to clinical is always my me time. I think about things I have learned, review goals, but in the end I just stare out my windows and see the town I left behind. It’s hard to believe that I “grew up” in this small rural town. And even odd still is that it has brown since I was here. I don’t remember a grocery store, or street lights, of street lamps for that matter. The road was two lanes, and now it is four. Even the highway has reflection lights and new signs for stores. So is it a New Rural New Mexico town?

My living room is larger than the clinic, and warmer, but I am starting to enjoy my white lab coat and the long sleeve shirts I use to use for my scrubs. As I walk in the door the quite air makes me feel a sense of peace. My clinical instructor, ever the whirlwind of energy gives me the first chart of the day and as I read a diagnosis of Hypertension and “Medication Refill” I think to myself, what a nice slow start.

I walk into the room and introduce myself and start to ask some questions and realize a simple medication refill is more than this man needs, and then I jump feet first into a 35 min assessment. Then another patient, another assessment and questions on health insurance, and billing. Can you afford these medications? What two things can we work on today? For the next month? What goals do you have? How can I help you with those goals? What is normal to you? How many do you take in one day? How bad is your pain?

Every room and every encounter is a stark contrast to my busy ED second life. In the ED I recommend patients follow up with their Primary Care Provider, here I am that person, I make those plans, I suggest those medications, I see what they can afford. It all feels so surreal, but yet so fulfilling.

I stopped by the grocery store that didn’t exist when I lived here; I wondered the endless isle and looked at everything. It brought back memories of riding my bike to the gas station to pick up candy and bread. “Are you Missy or Dani?” I heard from behind me. I turned “Missy” I said in reply. I didn’t recognize the man standing before me. “It’s me Jason, we grew up at Mountain View together” and instantly I saw the little boy I use to hang out with. We played war and shoot our BB guns the whole gang of us that lived there.

“I remember how are you?”

“Fine, fine just picking up some things for my family, we live just east of here. I have two boys”

“That’s awesome”

“I heard you joined the Navy”

“Army”

“Oh and are you home now?”

“Yeah, going to school and doing clinical out here at the clinic once a week”

It’s a small rural world and people might not change. Every day it feels strange to be back, as though I have seen rural, gone to big cities, gone to even smaller villages, and now my life is full circle. Giving back felt great today and I learned more tools for my bag of knowledge.

It’s time to go read now, have a test next week….until then, maybe I will see you around…..