Ask the (Student) Nurse!

Angry-looking nurse with stethoscope
This is how I look right before I give a mean patient an injection. (Kidding, kidding!)

Dear Queenjulie,

I know that some medications can interfere with the effectiveness of the birth control pill, but, once and for all,  do you have a list of which ones? I’ve read and been told different things different places. I’m especially thinking about Diflucan–the last doctor who prescribed it to me said that it could mess with the pill, but I’ve been given it by a few other doctors before and no one ever said anything about that. I’m obviously not having sex while I’m treating a yeast infection, but it would be good to know!


Itchy in Yeastville

Dear Itchy,

The big medications that we warn patients can interfere with birth control pills (BCPs) are antibiotics and St. John’s Wort. They can cause your body to break down the estrogen in your BCPs more quickly, meaning that it doesn’t stay in your system as long as it should. However, I checked several drug references, and as far as I can tell, there is no reason Diflucan would interfere with your BCPs. Pfizer studied Diflucan, and their report states, “There was no significant difference in ethinyl estradiol or levonorgestrel AUC after the administration of 50 mg of Diflucan,” which means that the body’s level of hormones did not decrease after taking Diflucan ( Actually, they went up!

Dear Queenjulie,

Last spring, I switched from the pill, which I was on for 8 years, to the Mirena IUD. I love everything about it – almost nonexistent periods, never have to worry about forgetting my pill, my sex drive has come back, etc., but here’s what I don’t like: since switching birth controls, I’ve started to have more breakouts and – gulp – more prominent facial hair. I’ve always had to groom a bit – waxing my upper lip and chin, but lately I can’t keep up with it. And I’m not talking peach fuzz – I’m talking about wiry whisker-y black hairs on my chin. Could this be related to a change in birth control? How are the hormones different? I was on Yasmin before. Or is this just me getting a little older (I’m 27) and my body just changing in general?


Not by the Hairs on My Chinny-Chin-Chin

Dear Not by the Hairs,

The difference in drugs between BCPs and a Mirena IUD is that a Mirena has only one drug in it: levonorgestrel, which is a type of progesterone. BCPs contain both estrogen and progesterone, so they have two kinds of hormones in them instead (unless you take mini-pills, which are just progesterone, but that’s less common unless you’re breastfeeding).

Mirenas should not cause hirsutism (the fancy medical term for getting hairy); however, they won’t prevent it, either. In contrast, the best treatment for hirsutism is birth control pills. So although your Mirena shouldn’t be causing the hair growth, it’s possible that you had it before and it was being suppressed by your pills, and you didn’t realize it. (Breakouts are a different story – yes, switching can cause them, and it’s incredibly annoying, and hopefully they’ll go away. I’m afraid I can’t do any better then that.)

Do any other women in your family have this issue? It can be genetic. Other then that, it’s probably hormonal. Have you ever been evaluated for polycystic ovarian syndrome? Getting hair on your chin and lip is a very common sign, but it’s usually accompanied by irregular periods and being overweight or having trouble losing weight, even when it seems like you should be. My advice would be, at your next Pap smear or physical, ask your OB-GYN (or even a general practitioner, if you prefer that or your insurance is better about it) about the hair growth – the best way to find out whether a hormone imbalance is causing this is a blood test to check your testosterone and androgen levels, and they may check your thyroid level and two hormones that have to do with ovulation, lutenizing hormone and follicle stimulating hormone, although if you have regular periods, those are probably fine.

Hi Glorious QueenJulie!

What was the process like for you to go to nursing school? I’m in the process of switching careers, and I have ZERO pre-reqs (except health statistics and quantitative techniques), but I know in my heart of hearts I’m supposed to be a nurse practitioner in a community health clinic. What was your academic path? Did you have pre-reqs before you went for your RN? Do you have a BSN? Is it important to have a BSN if you want to get your RN or NP? I know there are a lot of RN to BS programs “¦ I already have a BS in Public Health/Political Science so how important is it that I have a second bachelors in nursing, especially if I want to go to the master’s level of nursing? It’s exciting for me to think about going to nursing school because I know there is such a huge need for primary care givers right now and will be for a long time. I can’t wait, but in the meantime I have a ton of questions!


Your Future Colleague

Dear Future Colleague,

I’ll publish letters from anyone who calls me glorious. :) I’m one of the new generation of nurses who wasn’t a nurse first: this is a second career for me. I have a BA in linguistics and an MBA, and I spent twelve years working in publishing, mostly editing medical journals. When the economy went in the toilet and every publishing company was shrinking, or getting swallowed by bigger companies, or just closing their doors, I decided it was time to change fields. I had wanted to be a nurse when I was a little girl – I devoured every book about nursing I could find, especially the Cherry Ames series, but when I was in college, I was too scared to go to nursing school – the idea of having someone’s life in my hands scared the crap out of me. (Actually, it still does.)

My nursing program is at a community college (which seems odd after getting degrees from two different universities). I will be getting an associate’s degree in nursing (ADN). Theoretically, you could start a program like this right out of high school. In reality, however, it’s far too competitive, and they move way too fast to do the non-nursing classes at the same time as the nursing ones. There is no way I could take English 101 at night when I need those hours to prepare for clinicals at 6:30 the next morning, especially when I’m going to be caring for a patient with 18 different medications, six allergies, high blood pressure, uncontrolled diabetes, blood clots in her legs, and thyroid cancer.

So I took anatomy and physiology during the summer before I started nursing school, and a few other prerequisites. I definitely plan to do a bridge program that allows people with a BA in another field to go from the ADN straight to an MSN (master’s of science in nursing) without stopping for a BSN. An MSN is necessary to be a nurse practitioner — a BSN isn’t enough if you want to prescribe medications and diagnose diseases. Someday, I may even get a PhD; did you know you can be a doctor of nursing? Yep!

For someone with a non-nursing degree, I would find a program that you want to attend first, and see what they require. They will evaluate the credits you already have to see what they will accept. Then take as many non-nursing classes as you can and get them out of the way before you actually start. Nursing school is harder than even my master’s degree program was — it is intense! But it’s also amazing, and I totally recommend it.

–Glorious Queenjulie

Author’s Note: This is the Internet; it is not your doctor’s office, and I am not a doctor. If you are bleeding, or turning blue, or having some other type of emergency, please call 911! I give advice based on the best information I can find from my nursing references and other nurses, but it is only advice. Please don’t sue me if you don’t like it: I will go bankrupt and my children will cry because they can’t go to college. That said, send me your questions, issues, and gross bodily issues, and we’ll talk about them! E-mail me all your health questions at

By Queenjulie

I’m becoming a nurse because I really like sticking needles in people. I also like gangrene, benign cysts, crepitus, and weird lung sounds. I watch videos of IV insertions on YouTube for fun, and I make my kids let me practice using my stethoscope on them. I no longer hold my husband's hand while we're watching tv; now I hold his wrist so I can keep an eye on his pulse rate. He's remarkably tolerant.

9 replies on “Ask the (Student) Nurse!”

Hooray Nursing/Med School!!

I’m definitely going for my PhD in Nursing. I’ll be in and out of school my entire life. But all for the sake of community health I say.

Thanks for answering the question julie!

Who wants to make a group made up of primary care professionals/students here??

I actually have another question.

Do you know of a good guide as to the different levels of nursing certification? Specifically for the US. The differences in education and capabilities of LPN, RN, NP, and other alphabet soup things.

You’d think something like that would be easy to find on the internet, but nooooo.

Let’s see if I can do this off the top of my head:
An LPN/LVN (licensed practical nurse/vocational nurse) can go to a community college. It’s a 3 semester program at my school. It depends on your state law, but generally, they can do all the medical stuff everything an RN can do–except plan patient care and be a manager. They are right below RNs on the organizational chart. Basically, they have less responsibility than an RN.
RNs can have an associate’s degree in nursing (that’s what I’m getting), but most now have BSNs or even MSNs, and you get paid more for that. I plan to get an MSN after I get my RN license. IIRC, South Dakota is the first state to make a BSN mandatory to become an RN, but other states are probably going to follow them.

NPs have a master’s degree, and they can write prescriptions and diagnose diseases, just like doctors. In some states, an NP can run their own clinic all by themselves, although most places require them to be affiliated with an MD.

Finally, there are now doctorate programs in nursing. You can get a PhD, which is a research-based doctorate, or become a DNP, which is a Doctor of Nursing Practice; that is a clinically based doctorate. That’s the closest thing to an MD available now.

Thanks! The community college near me has an RN program, and I’m thinking that’s the best way to start. I already have my BA, so if I do decide to go for a BSN after that, it shouldn’t be too difficult (as long as I go to a state school, they have to accept all my non-major-related courses). Actually… now that I know it’s an option, I’m off to see if there are any schools near me where I could jump right into the BSN…. and there is one! Will definitely check out both programs now!

This is interesting! I’ve been told that I’d be a good nurse, and the field really interests me, but I am kind of afraid of having someone’s life in my hands. Also, I have an autoimmune disease, so it would be difficult to work with people with infectious diseases. I think I would be comfortable being an oncology nurse, and that way, the patients would be in the same boat as me when it comes to avoiding germs! (I am also comfortable around death and dying, which I attribute to how frankly we discussed issues like that in my family when I was growing up.)

Definitely want to hear more stories first. As it is, I wouldn’t be able to start a program until summer semester at least.

Becoming a nurse when you have an autoimmune disease is an interesting problem. You could certainly *work* as a nurse: There are so many different kinds of nursing, and as you noted, there are some that involve very little exposure to infectious diseases, like specializing in diabetes or cancer treatment or heart disease.

The issue is getting to that point–nursing school generally involves doing clinical work in a bunch of different areas, but primarily Med-Surg, which is the main ward of a hospital, and lots of Med-Surg patients have things like MRSA, pneumonia, influenza, and those sorts of things. My school also has rotations in home health and the public health department, which of course, have *lots* of patients with contagious illnesses. I don’t know if all schools do those types of rotations, however.

If you think you’d like to be a nurse, however, don’t let that stop you: Find a program you might want to attend, and call and talk to the program coordinator or whoever is in charge. Tell them about your illness and see what they say. In general, they’re going to find out about it if you get accepted anyway; nursing school requires a complete physical and up-to-date immunizations before you can start clinical work. I know there are several people with chronic illnesses in my class who don’t have any problem with their diseases interfering with school, and yours may be the same way.

I hope you give it a try! I love nursing, and I would recommend giving it a try to anyone who is interested.

I will definitely talk to someone in the department to see if it’s doable. I am not currently on immunosuppressants and, fortunately, my immune system rocks (knock on wood, I’ve never had strep throat, I rarely get bacterial infections, etc.). Okay, so it rocks a little too hard and gets a little too enthusiastic sometimes.

Having an immune system that overreacts is definitely better than one that doesn’t react at all, I would think! You should definitely talk to someone in the department; every school has a different clinical schedule, and it may turn out that yours doesn’t do very much work in an area that would be difficult for you, in which case, you’d have no problem!

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