Things I wish I had known about the McGill direct-entry master’s in nursing

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There are a number of things I wish I had known before I accepted the offer of a spot in the direct-entry master’s in nursing at McGill. You may still want to go into this programme, but these are a few of the things that I wish I had known, going into it. This may be of interest to people who are deciding whether or not to apply over the next few months.

It will not be possible to go to all your classes

The direct-entry programme schedules your clinical in conflict with other required courses. This means that you actually can’t possibly go to all your classes, because you have to go to clinical instead. Complain all you like, and the professors will agree with you, cluck their tongues and say it’s terrible, but nothing will be done to change it.

There are major administrative problems that the programme refuses to acknowledge

The venue of my first clinical assignment had no idea that my classmates and I were coming. McGill told us to go to a retirement home that had not invited us to come. We were a complete surprise to them when we showed up. Eventually we were given contact information for residents to follow, but the person that I was told had “volunteered” to be followed by a nursing student for the semester refused to meet with me, saying that she had never been asked, and that she was uninterested.

When I took this up with the professor running my clinical assignment, she expressed that she felt it was a failure on my part, that I would be marked accordingly and that I should have “done nursing” anyway. Attempts to clarify what she meant by “nursing” in this context were unsuccessful. Requests for help in this impossible assignment were considered hostile by the professors.

This sort of administrative failure was in my experience typical of the programme as a whole.

The direct-entry programme is not recognised by the College of Nurses of Ontario

This is a more recent development that occurred in January of 2012, but the direct-entry nursing programme recently lost recognition from the College of Nurses of Ontario, which means that it is impossible to directly apply for licensure in Ontario, and it may take a great deal more time and money to become a nurse in Ontario.

This may be fixed before you graduate, or it may not. Enter at your own risk. The administration of the programme generally don’t think that this is a big deal, but if you are planning on going to Ontario to practice after graduation, you may not be able to do so.

The programme is very expensive if you are not from Québec

I am a Canadian citizen, but I grew up in Ontario, and so for the purposes of tuition, I am not a Québec resident as far as McGill is concerned (even though I have been working and paying taxes in the province for the last few years). This means that tuition is higher for me. If you are coming from another province, you will be in the same situation. If you are coming from America or another country, it will cost you even more.

On June 28, 2011 I went in and asked the nursing department directly how much the programme would cost. They told me that there was absolutely no way that they could make an estimate, and that I should ask the registrar. I went to the registrar, who told me that they couldn’t give me any indication about the cost of the programme until after I choose my courses.

Come September, I was shocked to receive a bill for about $11,000 in the first semester. All told, I estimate that you should probably have somewhere in the area of $20,000 set aside for one year of the three-year programme.

You will receive no financial support from McGill

Students in the first year of the direct-entry programme are not considered to be full-time master’s students, since (for historical and administrative reasons) the first year is officially designated a “qualifying year.” Hence, if you request help from Financial Aid at McGill, they will decline to help you. I stood in line at Financial Aid and asked for help, and I was given an email address to contact after I filled out a questionnaire on my programme and financial status. Upon receiving and reviewing my questionnaire by email, I received the following response:

We are unable to assist you at this time.  Please contact us later on in the semester.  Remember to update your Financial Aid Profile if your situation should change.

In short, there was nothing that McGill could do to help. Be prepared for the worst. Look into bank loans. McGill takes an attitude toward direct-entry master’s of nursing students that could be best summed up as: “you’re on your own, and you should be ashamed for asking for help.”

Bullying within the programme

During my time as a direct-entry master’s student in nursing at McGill, I was attacked on a personal and academic level by professors in a number of different ways. I was told explicitly by two of my evaluators that a particular professor was giving them instructions to decrease my mark for reasons unrelated to my performance. They told me so because they were shocked that a professor would act in this way, and thought I should know.

By the end of my time as a student, I had absolutely no confidence that I would be given a fair shot at a decent grade in the programme. With this evidence that there was no relationship between my work and my mark, I lost any faith in the credibility of the school. I spoke to the Ombudsperson, who advised me that there was nothing that could be done.

Beyond concerns about my grades, I was the object of weekly intimidation from a particular professor during my clinical assignment. Every week, she would find me at the hospital to undermine me in front of my peers, and make my assignment a negative and humiliating experience for me.

I withdrew from the programme at the end of the qualifying year for this reason and for the reasons outlined above. The McGill master of nursing programme was the worst educational experience of my life and I cannot recommend it to others.

Recommendations for applicants

With all these considerations in mind, you may still want to pursue this as a career option, but be aware that there are some very serious issues with the programme as it currently stands. These issues may have been addressed in the time since I left, so I do recommend asking about each of these major categories specifically before accepting an offer of admission.

Here are some questions you may want to ask:

  • Will I be expected to keep up with courses that have conflicting schedules? For example, is it still “one of the first-year challenges” that pathology and clinical are scheduled to occur at the same time?
  • In which provinces is this programme currently officially recognised? Is it currently recognised in every province in Canada? How long has it been recognised, and has there been any changes in its official status in the last five years, as far as the colleges of nurses of other provinces are concerned?
  • How much will the programme cost? (Do not accept “we can’t tell you” for an answer. Press them on this. Try phrases like, “Will it cost more than $100,000 per year?” if they’re being stubborn about it.)
  • Is there any hope for financial aid for DE students?
  • What recourse do I have in case I experience abuse or bullying from my professors?

If there has been progress on these issues, or if you get an official response, I would love to see you post it in the comments below!

BibTeX

@online{bgcarlisle2012-2728,
    title = {Things I wish I had known about the McGill direct-entry master’s in nursing},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-12-16,
    url = {https://www.bgcarlisle.com/blog/2012/12/16/things-i-wish-i-had-known-about-the-mcgill-direct-entry-masters-in-nursing/}
}

MLA

Carlisle, Benjamin Gregory. "Things I wish I had known about the McGill direct-entry master’s in nursing" Web blog post. The Grey Literature. 16 Dec 2012. Web. 24 May 2017. <https://www.bgcarlisle.com/blog/2012/12/16/things-i-wish-i-had-known-about-the-mcgill-direct-entry-masters-in-nursing/>

APA

Carlisle, Benjamin Gregory. (2012, Dec 16). Things I wish I had known about the McGill direct-entry master’s in nursing [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/12/16/things-i-wish-i-had-known-about-the-mcgill-direct-entry-masters-in-nursing/


Toronto Spartan Race 2012

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Nursing Shoes

Nursing Shoes

This weekend was the Spartan Race in Toronto, which Alain and I did with Pickles and with a bunch of old friends. The Spartan Race is a 5k obstacle course that actually happened in Barrie on the 24th. To measure your personal performance, the organisers tagged each participant with a little microchip attached to the shoe. That way, it’s easier to identify the body/foot afterward, in case it gets lost, I guess?

In preparation, I took my old nursing shoes and cut grooves into the soles (they were completely smooth before) and wore those for the race. I’m glad I did this, because one of the obstacles was wading through 200m of waist-deep mud with barbed wire overhead. By the end of the race, I (and my shoes) were filthy, of course. I threw them out once we got back. I paid $25 for those shoes last September, and they were worth only $25. This is the most honourable death they could have had.

A wheelbarrow

A wheelbarrow

The actual race wasn’t so hard. I even did the climbing-up-a-rope thing (which I had never done before). In fact, I did all the obstacles correctly without having to do the penalty (20 burpees). Pictured to the right is me carrying a wheelbarrow with concrete and sandbags.

Murph over flames

Murph over flames

What was difficult was waiting for the bus at the end. We got in line for the bus and waited. And waited. And then the clouds came in and the sky got dark and it started to rain, and the temperature went down. Alain and I went under the towel that we brought to try to conserve our body heat, since we were wet and cold and stationary (being in line for the bus). It took an hour for the bus to arrive. They probably could have thought that through a bit better.

Now it's Alain!

Now it’s Alain!

The day after, we were informed by the Spartan Race that due to an electrical problem, about 1000 participants’ times were lost (including my time and the times of everyone I knew). I’ll never know how I did! That might be for the best, because I stopped for about 10 minutes at the beginning of the race to help a poor woman who broke her leg on the very first turn of the course. I felt so bad for her!

Hay bales!

Hay bales!

Weird thing to think about: my friends and I are now in the background of dozens of people’s Spartan Race photos on Facebook, and we have no idea.

BibTeX

@online{bgcarlisle2012-2933,
    title = {Toronto Spartan Race 2012},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-06-28,
    url = {https://www.bgcarlisle.com/blog/2012/06/28/toronto-spartan-race-2012/}
}

MLA

Carlisle, Benjamin Gregory. "Toronto Spartan Race 2012" Web blog post. The Grey Literature. 28 Jun 2012. Web. 24 May 2017. <https://www.bgcarlisle.com/blog/2012/06/28/toronto-spartan-race-2012/>

APA

Carlisle, Benjamin Gregory. (2012, Jun 28). Toronto Spartan Race 2012 [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/06/28/toronto-spartan-race-2012/


How seriously should I take my clinical evaluation?

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In nursing school at McGill, after every semester of clinical, there is a summary evaluation of my performance in the clinical setting. This evaluation includes a checklist of different things we’re graded on, divided into sections like “professionalism,” “technical skills,” “patient collaboration,” etc. Under each section, for every category, one receives a mark ranging from “unsatisfactory” to “meets expectations” and all the way up to “well above expectations.”

I have been sceptical about this mode of evaluation since last semester for a couple of reasons. First, I have a problem with the idea that one has to exceed expectations in order to receive full marks in a class. If I were to exceed expectations in certain ways, it would be very bad. Imagine if I took it upon myself to exceed expectations in the area of my technical skills and administer an IV medication. (This is something I have not been trained to do.) I would probably be expelled from the programme on the spot. But the biggest problem with this philosophy of evaluation is that you can’t, by definition, expect someone to exceed your expectations.

Setting that aside, my other major worry was that all the categories of evaluation were very subjective. I had no way to know if the marks I received were anything more than a reflexion of how much my clinical instructor liked me.

Fortunately, at the end of last semester, I noticed that there was one item on the checklist that was completely objective: The third box under “professionalism and responsibility” is an evaluation of punctuality—whether or not I showed up to clinical on time. This particular evaluation admits of absolutely no subjectivity or judgement on the part of the evaluator. It is something that I should be able to self-evaluate with complete accuracy, and there should be no variation between the mark I gave myself and the mark my teacher gave me. After all, my mark in this section should be a function of the time at which I arrived for clinical.

And so, I decided to do an experiment. I arrived at least a half hour early for every single clinical day this semester. There was not a single clinical day where I showed up on the floor and in uniform less than half an hour in advance of our starting-time. I didn’t do this in secret either. I made sure that my clinical teacher knew that I was there before she was, and that I was reviewing the chart before the day began.

My thinking was as follows: if I get anything less than “well above expectations” on my evaluation for that category, it means that there is some major disconnect between my actual performance and the grade I was assigned.

I received a mark of “meets expectations” from both my obstetric and paediatric teacher in that category. This was doubly shocking, because they had both explicitly commented on the fact that I was always early for clinical in the “comments” section.

I pointed this out to each of them in turn, and they were both very willing to change my mark. In the end, the difference between “meets expectations” and “well above expectations” doesn’t matter that much for this course. Clinical is pass/fail, and so if I had received a 100% in the course, I would get the same “satisfactory” mark on my transcript as if I had received a 65%.

That said, it’s hard for me to take evaluations seriously now. If even the grade I received for punctuality was coloured by the biases of my teachers, how much more were the grades I received in the more subjective categories affected by their prejudices?

BibTeX

@online{bgcarlisle2012-2811,
    title = {How seriously should I take my clinical evaluation?},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-04-13,
    url = {https://www.bgcarlisle.com/blog/2012/04/13/how-seriously-should-i-take-my-clinical-evaluation/}
}

MLA

Carlisle, Benjamin Gregory. "How seriously should I take my clinical evaluation?" Web blog post. The Grey Literature. 13 Apr 2012. Web. 24 May 2017. <https://www.bgcarlisle.com/blog/2012/04/13/how-seriously-should-i-take-my-clinical-evaluation/>

APA

Carlisle, Benjamin Gregory. (2012, Apr 13). How seriously should I take my clinical evaluation? [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/04/13/how-seriously-should-i-take-my-clinical-evaluation/


Diminished reality glasses

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Technology and autism

Recently, two of my classmates gave a class presentation on the subject of autism, which included the following video on the subject of Carly, a child with autism, who uses technology to communicate for the first time.

Carly is able to express herself by typing on the computer. This is a huge breakthrough for her and her family, and I think it worked because typing is a very linear and discrete form of communication—that is, you only type one letter at a time. Typing abstracts away many of the difficulties of verbal conversation and can be accomplished without the same level of motor coordination and timing that writing with a pen requires.

What struck me in the video was when Carly was asked, “Why do autistic kids cover their ears, flap their hands, hum and rock?”

She answered, “It’s a way for us to drown out all sensory input that overloads us all at once. We create output to block out input. … Our brains are wired differently. We take in many sounds and conversations at once. I take over a thousand pictures of a person’s face when I look at them. That’s why we have a hard time looking at people.”

Google’s augmented reality glasses

Recently, Google published a video about Project Glass (which I’m pretty sure isn’t another of their April Fool’s jokes) and it gave me an idea.

The principle behind augmented reality glasses is that you can add context-relevant input to your visual experience of the world.

Diminished reality glasses

So here’s the idea: I think that this technology could be adapted to help children like Carly. In the Project Glass video, the glasses are used to add extra information to one’s already busy visual field. But imagine that we first filtered out most of the busyness of the visual world with darkened glasses (not too dark—she should still be able to walk properly). Then we could use the same glasses to give pixel-by-pixel control to Carly over what she sees. We could also include noise-cancelling headphones that play white noise.

Carly says that she takes “a thousand pictures” of a person’s face, and so she has a hard time making eye contact. A single image, icon or word could replace a person’s face when Carly meets someone.

I think the way that the augmented reality glasses are demoed in the video would be ill-suited to helping Carly, but I think that they could probably be adapted so that they only display the information that Carly wants to see at the time.

That said, I have no idea if this would work in real life.

BibTeX

@online{bgcarlisle2012-2803,
    title = {Diminished reality glasses},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-04-7,
    url = {https://www.bgcarlisle.com/blog/2012/04/07/diminished-reality-glasses/}
}

MLA

Carlisle, Benjamin Gregory. "Diminished reality glasses" Web blog post. The Grey Literature. 07 Apr 2012. Web. 24 May 2017. <https://www.bgcarlisle.com/blog/2012/04/07/diminished-reality-glasses/>

APA

Carlisle, Benjamin Gregory. (2012, Apr 07). Diminished reality glasses [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/04/07/diminished-reality-glasses/


Obstetrics and Shakespeare

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Today was the last day of my rotation as a student nurse in obstetrics, and I have one regret from this semester that I think will haunt me for the rest of my life.

For those of you who don’t remember high school English class, in Macbeth, the title character learns early in the play that no one who is “of woman born can harm Macbeth,” which he takes to mean that he is invincible. Later on, Macduff reveals that he was “from his mother’s womb untimely ripp’d.” And then he kills Macbeth.

In January, I assumed that at some point over the course of this semester, I would have had the opportunity to refer to a child born by C-section as one “from his mother’s womb untimely ripp’d,” but it never happened. I even got to see a Caesarian birth from inside the operating room, but I didn’t think about it at the time.

Life slips away far too fast. If you’re not careful, all the opportunities you think you’ll have will pass you by.

BibTeX

@online{bgcarlisle2012-2767,
    title = {Obstetrics and Shakespeare},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-03-26,
    url = {https://www.bgcarlisle.com/blog/2012/03/26/obstetrics-and-shakespeare/}
}

MLA

Carlisle, Benjamin Gregory. "Obstetrics and Shakespeare" Web blog post. The Grey Literature. 26 Mar 2012. Web. 24 May 2017. <https://www.bgcarlisle.com/blog/2012/03/26/obstetrics-and-shakespeare/>

APA

Carlisle, Benjamin Gregory. (2012, Mar 26). Obstetrics and Shakespeare [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/03/26/obstetrics-and-shakespeare/


Risk-aversive behaviour

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For the past little while, I have been studying for my Health and Physical Assessment midterm, which was this afternoon. Up until Tuesday, our prof let us believe that any one of the six assessments we had been taught were examinable. On Tuesday, she let us know that it would be a random choice between only two—the head/ears/eyes/nose/throat assessment and the musculoskeletal assessment, which was a pleasant surprise!

But let’s imagine for a moment that the exam actually was a random assignment to one of six assessments, like we originally thought. Let’s also pretend that you were choosing between two imaginary strategies for studying for an exam like this.

The risky strategy

Using this strategy, you will be completely prepared, and guaranteed a grade of 100% on your exam, as long as you don’t happen to be randomly assigned to the neuro assessment, and in the case that you do draw the neuro assessment, you will be totally unprepared and receive a mark of 0%.

The conservative strategy

Using this strategy, you will be 80% prepared for all six assessments. No matter which assessment you are assigned on exam day, you will receive a mark of 80%.

If you were perfectly rational, you would have most reason to choose the “risky” strategy. This is because the expected grade outcome from making a decision guaranteeing a grade of 100% 5 times out of 6 is 83%. Another way of saying that is that if you were to write a large number of exams using the risky strategy, you would expect, over the long run, to get an average grade of 83%. The expected grade outcome for the conservative strategy is, of course, 80%, for the same reason.

The common objection is, But what if I choose the risky strategy and happen to be randomised to the neuro assessment? The answer to that question is, That would suck, but you would still have made the correct decision. Decisions should be evaluated ex ante, not ex post. To adopt a rule for one’s decision-making that endorses the conservative strategy is to adopt a rule that cheats oneself out of an average of 3% per evaluation.

What’s interesting about this result is that if you were to ask any of my classmates (I asked a convenience sample already), they would unanimously say that they prefer the conservative strategy, even after explaining (and them agreeing) that such a choice is irrational. This means that, in at least this case, nursing students at McGill are willing to give up 3% of their grade for nothing but the certainty of knowing what their grade will be beforehand. This is what economists call “risk aversion,” and there are more scientific ways to measure it.

I think I’d roll the dice and go for the 100%.

BibTeX

@online{bgcarlisle2012-2750,
    title = {Risk-aversive behaviour},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-03-16,
    url = {https://www.bgcarlisle.com/blog/2012/03/16/risk-aversive-behaviour/}
}

MLA

Carlisle, Benjamin Gregory. "Risk-aversive behaviour" Web blog post. The Grey Literature. 16 Mar 2012. Web. 24 May 2017. <https://www.bgcarlisle.com/blog/2012/03/16/risk-aversive-behaviour/>

APA

Carlisle, Benjamin Gregory. (2012, Mar 16). Risk-aversive behaviour [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/03/16/risk-aversive-behaviour/


Tricky exams for health practitioners

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A couple years ago, I read a story about a medical student who was tricked by his professor. In this story, the professor asked the student to assess a patient’s retina, and told the student that he should expect to see a certain pattern of blood vessels on the retina. The medical student examined the patient’s eye and agreed, claiming to have seen it as well. Much to the embarrassment of the medical student, the professor then revealed that he was examining a glass eye.

I’m scared to death of this sort of thing happening to me.

Today I had a mock exam in my physical assessment class. Because it’s an exam situation, we’ve been told that we’re supposed to expect a normal, healthy standardised patient (SP), and so if we’re nervous and can’t actually find a pulse, for example, we can just say a pulse rate that would be normal for a healthy adult. I happened to be randomly assigned to the head/ears/eyes/nose/throat scenario, and one part of this assessment is examination of the SP’s tonsils.

I looked inside my SP’s mouth with my penlight to look at his mouth, tongue, the insides of his cheeks and his tonsils. The tonsils are supposed to be just visible around the sides of the back of the throat, and sometimes they’re not visible at all. I couldn’t see the tonsils, but rather than just writing down “tonsils +1,” I took the tongue depressor out and asked, “Have you had your tonsils removed?”

I felt like I dodged a bullet when he said, “Yes, they were removed three years ago.”

BibTeX

@online{bgcarlisle2012-2743,
    title = {Tricky exams for health practitioners},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-03-14,
    url = {https://www.bgcarlisle.com/blog/2012/03/14/tricky-exams-for-health-practitioners/}
}

MLA

Carlisle, Benjamin Gregory. "Tricky exams for health practitioners" Web blog post. The Grey Literature. 14 Mar 2012. Web. 24 May 2017. <https://www.bgcarlisle.com/blog/2012/03/14/tricky-exams-for-health-practitioners/>

APA

Carlisle, Benjamin Gregory. (2012, Mar 14). Tricky exams for health practitioners [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/03/14/tricky-exams-for-health-practitioners/


Pathology midterm results

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My pathology midterm was three weeks ago. I went to the exam feeling cautiously optimistic, but when I started talking to my classmates in the hall before the exam, my confidence was shaken. I wrote the exam in my usual way: I answered the questions as quickly as possible and then left before I had a chance to turn correct answers into wrong ones. I didn’t feel very good about my performance afterward. I felt a little bit better when a classmate mentioned that she also had a lot of 5’s in a row, but I still had no idea how I did, and I feared the worst. I mean I actually was afraid of receiving a failing mark.

Yesterday I finally decided to check my grade online. I did really well. Unexpectedly well. Suspiciously well.

This, on the one hand, is great news. Who doesn’t want a good result on a challenging exam? The only problem is that it was a multiple choice exam and so I don’t know whether I just happened to guess the correct answers, or if it wasn’t as difficult as I made it out to be in retrospect. I don’t know if I was adequately prepared, or if it was just a stroke of luck.

To be certain, there were a number of questions I wasn’t sure of, but then, because of the structure of the exam itself (it was multiple multiple choice) I was able to narrow down most questions I wasn’t sure of to two or three options.

I suppose in the big world of academic problems that I could be having, this one’s not so bad.

BibTeX

@online{bgcarlisle2012-2738,
    title = {Pathology midterm results},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-03-7,
    url = {https://www.bgcarlisle.com/blog/2012/03/07/pathology-midterm-results/}
}

MLA

Carlisle, Benjamin Gregory. "Pathology midterm results" Web blog post. The Grey Literature. 07 Mar 2012. Web. 24 May 2017. <https://www.bgcarlisle.com/blog/2012/03/07/pathology-midterm-results/>

APA

Carlisle, Benjamin Gregory. (2012, Mar 07). Pathology midterm results [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/03/07/pathology-midterm-results/


It’s midterm week and what is wrong with Google Docs?

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It’s midterm week right now, so I’m behind in my blogging. Apologies! I promise I’ll write a whole lot more when I get back.

Google Docs preferences

Google Docs preferences

In the meantime, here’s a little bug I’ve found in Google Docs, and it’s one that has come up recently, because I have been actively using this feature, and I’m not sure how it broke.

Google Docs has a great feature: automatic substitution. When you type “(c)” and then hit the spacebar, Google Docs immediately changes your “(c)” into a “©” like magic! There was one substitution I was using all the time, namely, the “–>” into “→” substitution.

I specifically remember having used it in January extensively in my notes.

If anyone has a tip or a clue as to how to fix this, that would be appreciated. Google’s documentation is lacking. I’ve done a few searches, and found nothing helpful.

Failure to replace

Failure to replace

I’ve checked my Google Docs preferences (see previous image) and the other substitutions work fine, but no matter what I do, I can’t get it to change my “–>” into a “→”.

BibTeX

@online{bgcarlisle2012-2710,
    title = {It’s midterm week and what is wrong with Google Docs?},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-02-15,
    url = {https://www.bgcarlisle.com/blog/2012/02/15/its-midterm-week-and-what-is-wrong-with-google-docs/}
}

MLA

Carlisle, Benjamin Gregory. "It’s midterm week and what is wrong with Google Docs?" Web blog post. The Grey Literature. 15 Feb 2012. Web. 24 May 2017. <https://www.bgcarlisle.com/blog/2012/02/15/its-midterm-week-and-what-is-wrong-with-google-docs/>

APA

Carlisle, Benjamin Gregory. (2012, Feb 15). It’s midterm week and what is wrong with Google Docs? [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/02/15/its-midterm-week-and-what-is-wrong-with-google-docs/


The fifth vital sign is …

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If you ask a nurse what the four vital signs are, you’ll get a fairly standard response:

  • Heart rate, e.g. 60 bpm
  • Blood pressure, e.g. 120/80 mmHg
  • Temperature, e.g. 36ºC
  • Respiratory rate, e.g. 12–20 per minute

But the “fifth vital sign” has been defined by different teachers that I’ve had in at least four different ways. I have had at least one nursing professor tell me explicitly that each of the following is the “fifth vital sign”:

  • Pain, e.g. 2/10 (PQRSTU)
  • O2 saturation, e.g. 97%
  • Blood glucose
  • Alertness and orientation
  • Comfort, appraised subjectively by the patient

Has anyone else been told by a nursing professor that something else is the fifth vital sign?

BibTeX

@online{bgcarlisle2012-2688,
    title = {The fifth vital sign is …},
    journaltitle = {The Grey Literature},
    author = {Benjamin Gregory Carlisle},
    address = {Montreal, Canada},
    date = 2012-01-27,
    url = {https://www.bgcarlisle.com/blog/2012/01/27/the-fifth-vital-sign-is/}
}

MLA

Carlisle, Benjamin Gregory. "The fifth vital sign is …" Web blog post. The Grey Literature. 27 Jan 2012. Web. 24 May 2017. <https://www.bgcarlisle.com/blog/2012/01/27/the-fifth-vital-sign-is/>

APA

Carlisle, Benjamin Gregory. (2012, Jan 27). The fifth vital sign is … [Web log post]. Retrieved from https://www.bgcarlisle.com/blog/2012/01/27/the-fifth-vital-sign-is/


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