Any Suggestions for the New Guy?

[RN4MD]

I know that I have a long road ahead of me. When I went into nursing school, I had a 2.7 GPA. At graduation, I raised it to a 3.47 without retaking any classes. The classes I need to retake for a more solid foundation for medical school are the ones that are keeping my GPA below a 3.7. (I joined and led a sorority in the first three years of school and then left for the military for 3 1/2 years before returning for nursing school.) I have no doubt that I can raise my grades...

... what my question to you is what you may suggest from your individual experiences that may benefit me in the long road ahead of me. There are terms you use that I don't understand... EC's = extracurriculars? I know that the acceptance rates of BSN's into medical school are pretty low, but I am unwaivered as I am sure that, as a non-traditional student, I have had much more life experiences and, having been through the ICU experience, have been exposed to trauma and death without doubting my current profession (but only wanting to expand on it). Also having been engaged to a doctor (and me leaving for reasons that can be reflective of his fault through legal records that I would rather not have revealed to an interviewing committee for medical school), I know what medical school and internship is like from having lived with him and heard ta plethora of stories while we were together. I know what I am getting into, and that is not the scary part. From this point until waiting for any acceptance letter is what paralyzes me.

I also want to congratulate those who got into medical schools and Best Wishes to those who are applying. On my floor there are fourth year medical students who intermittently come up to the ICU and shadow a doctor, even act as a "subintern" for non-emergent cases without the allowance of giving orders but more of an informative relay in their learning process. I congratulated one female, and she looked shocked, as if she had never heard those words in her life; I think she forgot that some people respect what she and others had gone through to get to that point.

Thanks for reading to this point.

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[Tweetie_bird]

just bumping it up for you so others can read it.

 

[Adcadet]

Originally posted by RN4MD

... what my question to you is what you may suggest from your individual experiences that may benefit me in the long road ahead of me.

I'll throw in my $0.02. Bear with me; I'll try to define every "technical" term I use.

Well, I think the basic advice is important for you as for anybody else - get your GPA up, especially the BCPM (Biology, Chemistry, Physics, and Math; basically, what AMCAS - American Medical College Common Application Service - consideres "science."). Rumor has it that med schools weight BCPM GPA a big higher than AO (all other; basically, your total GPA).

Next are your MCAT scores. These are often considered the "great equilizer" - someone from Harvard with a 3.9 but crappy MCAT scores is dead; someone from Podunk State and a great MCAT has a shot. Since your non-traditional, you may be a bit more able to arrange your schedule so you can rock the MCAT. Take it in April - August of the year you're applying is too late. And it can't be more than 2 years old, generally. Study for this test for at least a semester just like it's another class. And do many full-length practice tests - this test is an endurance test.

Next are ECs (extra-curriculars). Since you are an RN (I think), you may have some really great ways of showing your dedication to medicine beyond the usual nursing jobs. I think doing two great ECs is a good idea. Doing many ECs but not putting much time into them is a waste, so choose a few and make them count!

Next is research. Some consider research just another EC, and that's fine. If you like research, do research. Since you have a solid health care background, perhaps doing some research, even clinical research, would be a great way to round out your application. Furthermore, if you're afraid that people will look at the BSN and think you don't really know any hard core science, doing some basic research might be a good way to dispell that myth. Research supervisors are great for LORs (see below). Oh, and some schools specifically ask about research - U of Chicago Pritzker, and Duke, I believe.

Next are LORs (letters of recommendation). Make sure you get to know your profs, as you'll probably need two science LORs, maybe one non-science LOR, and it's probably a good idea to get a job/research LOR and an EC LOR. Of course not all schools will require all of these, but it's important to have the bases covered.

Application timing - get your AMCAS in as early as possible - think June. This helps a lot.


So, are you finishing your BSN? Have you graduated and are now taking your pre-med classes now? Are you working?

Hope this helps. Feel free to ask more questions and give more background on yourself! Feel free to PM me if you want.

Adcadet

 

[Cerberus]

Any Suggestions for the New Guy?

Always bring a towellll

 

[Tweetie_bird]

Originally posted by Cerberus
Always bring a towellll

with all the crying I've been doing lately, I'll second that suggestion. It's a tough road.

 

[RN4MD]

So, are you finishing your BSN? Have you graduated and are now taking your pre-med classes now? Are you working?

Thank You to Adcadet, Tweetie_bird, and Cerberus for responding... bring a towel. (*chuckles*)

To answer your questions, Adcadet, I am finished with my BSN. I work in an Medical ICU that serves also as a fallback to Cardiac and, at times, Surgical ICUs. It is intense for a first nursing job, but I used to work in the hospital's Pediatric ICU. After having been there and seeing what I did as a tech, I overcame the "pulling of the heart strings" early on and learned not to take work (i.e., patients) home with me. Not having children probably helped as well.

I work full time midnight shift, 2 12-hours and two 8-hours, per week. I tried to take classes immediately after graduation without taking into consideration the difficulty of adjusting to the graveyard shift and therefore dropped my first semester. There is a learning curve to this job that I never expected that I was warned about by many people, but I am too stubborn to think anything is too difficult for me. 29 years old and I still learn the hard way.

When I say that I am starting over again, I mean from square one, college algebra and general chemistry part I. I have early registration this time around, so I can be more strategic about the times to schedule classesas well as knowing how to request a regular work schedule (which would help greatly).

I am about to sound completely pathetic and lucky at the same time, but I moved home with my parents after graduation to pay them back the money they loaned me while I was in school. Although I don't have rental bills to pay (electricity, gas, etc.), I allocate a direct deposit to my account for $400 biweekly and everything else (OT, midnight bonuses, shift differential, etc.) goes to them. They are very encouraging for me to return to school and have offered for me to stay as long as need be, but, upon discovery of a certain prescription to help sexual dysfunction in men hidden deep in the medicine box that my father uses, I have insisted that one year should be enough to repay the majority of the debt. (Thank God I work midnights.) (Thought you would get a kick out of that.)

I could sit here and write to you a different scenario that I encounter every night regarding work. For instance, I had a patient with liver failure from an accidental Tylenol overdose (history of back surgery with spurs, self-treatment with Tylenol and prescribed Morphine). The patient was in the hospital and suddenly became short of breath and hypoxic, was intubated, and brought to my unit. Because the intubation is so irritating, sedation is initiated using one of a select menu of drugs. This particular patient had propofol ordered and hung. Not only did this drug not work for this patient as he was still restless and fighting the tube (biting on it to impede the airway, turning head back and forth to get tube out himself), but propofol is lipid-based and increases the already-elevated levels of amylase and lipase in this patient; basically, it's rendering the patient's pancreas and liver susceptible to irreversible damage, if it is even reversible by the time we see them. So, the wise thing to do is to switch over to a drug more hepatic-friendly, such as Ativan or Morphine. Unfortunately, the clearance rate for either of these drugs is much slower than propofol. (When patients are on sedation, physicians prefer to have an AM drug holiday, where the sedation is lightened enough so that an adequate neurological assessment can be done to determine if the patient can tolerate being extubated, if they can "wean" or breathe on their own without the vent help and without overexerting themselves. Propofol allows for rapid waking-up and helps when a wake-up and extubate is to be done.) The physicians kept wanting to try to extubate the next day (for the past 5 days), but the patient was not ready, relating to encephalopathy from probable secretive alcoholism (common), as he had some shakes (not quite rigors) and a cognitive aspect that weaved from appropriate to confused and combative. At the last minute during their day, the MDs would decide to let the patient go "one more night", and, after 4 days, his hepatic labs were going alarmingly high. So, being a nurse and having the ability to switch meds under the sedation protocol, I turned off the Propofol and hooked up Ativan and Morphine drips. (This was with the advice of the charge nurse who was assessing the agitation of the patient with me trying to decide what was more important: improved comfort and thus oxygenation and rest for future extubation, whenever they decided to attempt it, to allow the agitation for an assessment that would occur in 10 hours, or to turn up the propofol to aid in comfort but at the sacrafice of the enzyme levels.) I knew that the drugs would take longer to clear, but (1) his respiratory rate had stabilized into the teens rather than the 30's, (2) it was treating his back pain to help him rest, and (3) it gave him a chance to lower his triglyceride levels. My shift is over by the time the docs come to do rounds, so I didn't get to hear if the service he fell under would be upset with me for doing the switch on a night another service was on call, and with the House Officer who, two nights ago, wrote the sedation protocol to expand our options to treat his restlessness and pain.

Interesting? That is what you call one situation that one intern will face in a given night on-call, not to mention the issues of the other 19 patients they are responsible for: the BMT (bone marrow transplant) who is rejecting her stem cell transplant and becoming septic; the esophageal variceal bleed from liver failure whose BP and O2 are dropping due to blood loss; the smoker who acquired acute respiratory distress and whose lungs will not respond to the antibiotics, steroids, or ventilation support; the bilateral lung transplant patient whose anxiety from a prolonged hospital stay causes her to desat in the middle of the night when she wakes up disoriented; the bipolar woman who drank Weed-B-Gone so she'd be gone after a fight with her husband... there are stories. There are Frequent Flyers you see at least every other month for one reason or another. The Gomers or older people with 100 different diagnoses who by all standards should die but somehow don't. The Angels who have cancer whose life is taken way too soon but who still hold their head high to fight and worry not about themselves but if they are being too much trouble for you.

For every night I have a difficult patient or a demanding double assignment, I think I may learn one more thing that night that will put me that closer to understanding medicine more.

Hope you enjoyed all that.

Thanks again for your responses..... Graveyard Nurse

 

[Adcadet]

interesting indeed! I think you'll be able to write a great personal statement and essays based upon your experiences, not to mention the interviews. But the first step is to get those pre-reqs done. Good luck with those!

Just out of curiosity, are you male or female?

 

[Random Access]

Originally posted by Cerberus
Always bring a towellll

Anyone else think of the duck job? Okay, yes I'm sick....

 

[Samoa]

Good call on the Ativan. Sedation vacations are slightly less important than oxygenation...

I wish you lots of luck when you're ready to apply! Be sure to keep us posted.

 

[RN4MD]

Adcadet, I take it you ask of my gender because of the stint in the Marines. Or did I even mention that? I was in the Reserves for 3.5 years, but I took every active duty assignment (most of them just on base) while trying to figure out what I was going to do with my life. I am female. (No, I am not some monstrous, overmuscled, Russian-looking woman you would expect to see joining the military.) And I have no minority to claim... my dad is a thoroughbred Czech/Slovak (minus the historical Turkish invasion of Europe) and my mom is a Northern European mutt. I didn't know if that was going to be your next question.... but I figured I would shove that in there.

Well, I happened to be sitting in a bar waiting for a date this past Thursday night when I met one of the directors for undergraduate admissions at the university I have been trying to get into (but my admission has been postponed pending claiming a major that coincides with premed and my work schedule). He gave me his business card and proposed that I call next week to research who I should talk to. Talk about luck!! (That and my date actually did show up. I am two up.)

I had a comment thrown to me last year when I spoke to an intern at the hospital regarding her experience with medical school. When she asked if I was thinking of going premed, and I replied yes, her response was (and I kid you not): "Oh, dear, you're too pretty to be a doctor. Just marry one." ..... I was so dumbfounded I must have reiterated all of the blonde jokes she ever heard in her life, as I just stood there standing with my mouth open ready to catch some flies. Little did she know I almost did...

Trust me, I still sit and struggle with studying chemistry without the benefit of class. I am trying to exercise persistence, though. At least chemistry I can do without a lecture... biology, on the other hand, has topics more selectively covered depending on the prof, so I wait on that. I feel like a spinster sitting at home at 3am during the week studying when I have nights off and can't talk to anyone because even midnighters sleep the night shift when they are off work. At least the distractions are reduced by lack of company and infomercials.

So, is everyone who has been following with this traditional students? Am I one of the rare "Mature Premeds" on this site? I would ask questions to find out about everyone, but not sure what to ask... I never talked with extensively through a website before, and it seems that everyone here knows each other pretty well...

And what is that about ducks?

 

[Adcadet]

RN4MD -
I was asking about your gender purely out of curiosity. I'm sure your gender will play some role in preparing for medical school, but I have no idea how.

I'm a bit older than many here - I'm in the second year of my two-year MPH. I'm 23. I know there are many here who are older. You can always try olderpremeds.com (not sure if that's the right URL).

 

[nappy kat]

RN4MD, I was also in the marines, I am currently finishing my bsn, and I also might attend medschool. We have so much in common, but I am male .

 

[UrSexyLatinDr21]

Welcome to SDN RN4MD!!

I know that the acceptance rates of BSN's into medical school are pretty low RN4MD




About this issue that the acceptance rates of BSN's acceptance into med school are pretty low, there are many factors that affect the fact. I work in an Emergency Room and by talking to several RNs, MDs, DOs, and some of my friends whom current major is a BSN, but still premed is that not many people with a BSN apply to medical school, thats why the acceptance rate seems much lower compared to Bio or science majors. Also, Have you heard the , " The major doesnt matter", as long as you have the pre-reqs and MCAT you can apply to med school. As the premed advisor and some other people have told some of my friends, just be sure to explan why BSN to MD? I found your answer very reasonably: "I want to expand some of what I know"..Great! Like my friend said, When I started doing clinical rotation I felt I wanted to do more for the patients and being a dr could give me the opportunity of doing so! I just wish you the best of the luck and I know you will do great! same to you nappy kat! Dont let external comments bring you down, bring your hopes down that having a BSN will not let you get into med school, nor will be harder. This is a very weird/random process as many of you guys know! Good Luck and kick ass on those pre-reqs and MCAT!

Eduardo

 

[UrSexyLatinDr21]

BUMP

 

[UrSexyLatinDr21]

BUMP!!!

Eduardo

 

[RN4MD]

Adcadet, you sound more mature than 23. Maybe I've just been exposed to the "young" ones on campus lately. Take it as acompliment.

And for Nappy Kat, Hoorah Devil Dog! I give you credit for going into nursing post-service. Fellow Jarheads teased me that I went in for the 10:1 male:female ratio (after hearing them talk, I figured they would make better body guards than anything)... I suspect you are subject to the same considering similar gender proportions. Realize that, if we ever went back to the military post-medical school, we would have to join as officers in the Navy or Army... but could request to be stationed at Camp LeJeune or Pendleton with the "Men's Department of the Navy." ... Hang in there with nursing. The odd loops they make you jump through.. (Did you have to checked off on making a bed, too? As if we didn't know how to dress a rack...) And then to consider graduate school before graduating. When I vocalized my considerations, I had a flow of input from nurses: "You need to relax, you're just about to graduate!" "Take time off, pay off some debt..." "...but you haven't given nursing a chance!" and the best, "Traitor." !!! The more exposed to nursing I get, the more I realize it is a cut-throat battle to climb the ladder and step on whoever gets in the way, but smile at each other the entire time. I'm not interested in surging forward politically in nursing, so I am no one's threat... but to stand back and watch this is dissappointing if not reiterating to not make it my life career. I hope you are not exposed to this; being male, you may be spared. I hate to even say such horrible things about where I work, even being the new guy, but the truth of the operation is hard to deny.

[What's even more interesting is the reaction from "seasoned" nurses when the new interns make a mistake. They are instructed to tell the nurses to call medical students on call to present various problems with their patients. This gives the 4th year student hands-on experience in the ICU as an MD, although they can't give orders or participate in direct patient care; it's the student's opportunity to apply knowledge first, then talk with the intern with what they come up with. Example: The nurse can call the medical student for a problem like an order for sliding scale insulin for a diabetic was not written upon admission. The medical student can write one up per protocol, have the intern sign it, and the nurse has the order. When a patient's systolic blood pressure is 65 and the heart rate shoots up from 90 to 120, the nurse should call the intern; it's emergent, and talking with the medical student wastes time. A couple of interns have reiterated to the nurse to call the student. The nurse tells the nurse manager, who goes through the chains to write up the ntern, who gets "counseled." Then the intern is mad at the nurse who spoke up. Then the nurse tells everyone else, and all the senior nurses think that the intern in question is incompetent. It goes through the network to even the new nurses, and the reputation follows them. One intern got yelled at by a GI fellow for not knowing about a specific patient when on-call, and when he went to the nurse after the verbal lashing to have certain drips shut off, the nurse (who had a tiff with the intern two weeks earlier and knew that the intern was in trouble) said she would "get to it" when she was done charting. (She could have gotten to it or had another nurse shut them off, but she chose to let him wait. The intern then turned around, walked back into the room after the fellow left, and went right down the line, shutting off all the pumps and leaving. When the nurse walked into the room 10 minutes later, there was backflow into all the lines, and half of them were occluded and needed to be pulled. Moral of the story - and it is sad that this takes precidence over patient care with stubborn people: Be nice to your nurse, and your nurse will be nice to you. Not everyone is like that; heck people have bad days all the time. On-call nights are not always easy, especiallyin the ICU, so you would think that nurses would be a little more forgiving, especially with most of them having experienced PMS and/or hot flashes. (*Sigh*). Nappy Kat, all I can say is hang in there. It's always the one patient that appreciates you that makes it all the more worth doing for everyone else.

UrSexyLatinDr21 (Eduardo), what is a bump? (I've never "bumped" on the internet, and I don't think Ithat would be implied on this type of website...) You are correct on the amount of nurses who (don't) apply to med school. (See the comment "Traitor" above, hence an insight to the sentiment of those who do purspue it.) I would think that more who get into health care who see people making decisions and assessing the patient would want to know more, to get into the nitty gritty of assessment, x-rays, lab values, PMH, etc., and put the pieces of the puzzle together... and to follow up to maintain that homeostatic/hemodynamic balance. Maybe part of it is that many are married and have someone in their lives who may be the checkbook holder, the investment broker, the determining factor of the destination of residence and expansion of family, someone else at their side or right above them to make decisions. I don't have that... experienced solo flyer? Family gypsy? No ball-and-chain - men or children?? Sorry, getting philosophical and wordy.

But I still want to know what a bump is. (no wheals, papules, etc...)


You know, I have never talked to anyone so much on a websit before. You all must be entertained. I hope these things I tell you are interesting about the hospital. When I have more time, i ahve a couple of priceless ED stories I'll have to post for your entertainment.

 

[GoodMonkey]

Originally posted by Random Access
Anyone else think of the duck job? Okay, yes I'm sick....

yep. i did. sick right there with you!