NursingZen

As it turns out, at the end of Week 3 everyone I talked to in the program was in the same boat: Partners felt neglected, couples argued, time seemed to slip away, tensions mounted. I think it’s funny that we all hit the wall–and were scaling it–at the same time.

Unfortunately, some people hit the wall harder than others: They wonder whether they’ll make it another day, whether nursing is for them, whether another program would’ve been better organized, and whether all accelerated programs are as crazy and intense as UCSF’s.

I feel for them. We all worked hard to get to this stage and it can be soul-wrenching to feel like the program may not be what it was cracked up to be, or that nursing may not be what one hoped for or expected. But I hope they don’t leave. We’re just getting started; former MEPNs have said that the first quarter is the toughest because we’re all getting adjusted.

Meanwhile, to my surprise, the anxiety and fear I felt leading up to and during the first two weeks of school have melted away!

Something clicked for me during my second week of clinicals: I like nursing. I really like it.

I like the fast pace, the constant, never-ending learning, the gross stuff, the sad stuff, the teamwork, the blend of social work, science, medicine, sociology, anthropology and psychology…It’s an amazing thing. There’s no field like this. (Yes, tag me “Idealistic” right now.)

And I can just go on and on about my admiration and respect for the nurses I’ve met and seen in action. They make me want to become an excellent nurse–no less.

I’m also relieved to have something to focus on, to be back in school, to have readings, tests and discussions that are applicable to real life, to meet new people. I can’t imagine myself doing anything else right now but be in this program.

Wow, these feelings blow me away. Is it really me who’s talking?

On the Saturday of the end of the second week of school, I was lying in bed wondering why I was so exhausted. Then it hit me: the enormity of what I’d taken on for the MEPN year.

The timeline is staggering when you really think about it:

• By the end of the summer quarter, in August, we’ll be allowed to give medications to patients.
• By the beginning of the fall quarter, in September, we’ll be continuing to shadow a nurse but will be responsible for total care of one patient throughout a 12-hour day.
• By the end of the fall quarter, in December, my instructors said: “We will be stepping aside and watching you take care of four patients.”

One year from now I will be taking the RN licensure exam and applying for jobs.

The following week, Week 3, my man and I got into some arguments. He was frustrated with my preoccupation with school and my inattention to him. Intellectually he understands that we’re in an adjustment period and that we’re going to be on different wavelengths for a little while. I promised to do my best to attain balance.

I can’t decide what I’m looking forward to most:

A) Change the dressing of a Stage 3 or 4 wound

B) Insert a nasogastric feeding tube

C) Change & clean out a colostomy bag

Each week we’re introduced to a set of skills that we’re then let loose to perform in the hospital (with supervision of course). When I first saw a pic of a Stage 4 wound (meaty with bone showing), I thought wounds would be my worst fear. But by the next week, (A) had been upstaged by (B). And then this week… (C) is at least tied with (B). I’ll be actively seeking out these things at clinicals because the fear and anticipation of having to do them is driving me bananas.

A brave classmate offered to let a student practice (B) on him (up the nose, down the throat and into the belly):

I finished my second week of clinicals last week. I shadowed a nurse who was my age and had been working for only eight months. She already seemed jaded and bitter, which made me sad and anxious. She echoed what I’ve heard from every nurse: The first year is the toughest to get through.

It’s been fascinating to see the different personalities and nursing styles. Most of the nurses I’ve observed are very organized and on point, but some handle the stress better than others. I’m realizing that a sense of humor is essential for survival. I’ve been lucky so far to not be with the nurse who yelled at my classmate for spending too long chatting with a patient and another one who talks to her adult patients like they’re kids and does only the minimum she can get away with.

Update on the 56 year old farmer with very aggressive thyroid cancer: He moved to a more acute wing. I visited him. Since he can’t swallow, he has a feeding tube now and currently he can’t talk. I was overjoyed that he remembered me. He and his wife maintained big smiles and a sense of humor even though his prognosis is bad: 100% of people with his aggressive cancer die; the docs give him 3 months. I left the room teary-eyed.

Soon I’ll post a photo of my horrendous hospital uniform…and nursing shoes that are so-ugly-they’re-trendy (at least in NY!)

For July 4th, I partied as though I didn’t have to be up at 5 a.m for my first day of clinicals at the hospital. Excitement and a hangover woke up my mind at 4:30 a.m. I slowly brought my body out of stasis with three unbearably stiff sun salutations.

6:45 a.m. at the hospital: The buzz around the nurse’s station was the true wake-up call. Until then it hadn’t fully registered in my mind that there were nurses working while I slept, and care was truly being provided 24 hours a day.

I also never realized how many hip, young, good-looking nurses there could be in one place. Dang. Meanwhile, we students looked liked tired lemmings.

The preceptor I was assigned to fit the former description too. She was nice but not sweet, a badass but not a hard-ass. She could be professional one minute, then shoot off a wisecrack or flippant remark another minute. I could tell she wasn’t thrilled to have someone shadowing her for–how did she put it—“the rest of our lives”—but she knew it was important and she took me on seriously and with intention.

Hour 1, 8 a.m.: My preceptor gets organized for her four patients of the day. Night-shift nurses give reports on patients to morning-shift nurses. Good communication and listening are essential.

Hour 2, 9 a.m.: My preceptor helps an obese (400-pound) woman on to her bathroom commode. She then conveniently says, “You can do her blood pressure, right? I have to go do something,” and runs off. While the patient has a long and labored No. 2 in the commode, I tryto take her blood pressure. But the cuff won’t fit properly. I don’t know what to do–Am I supposed to leave her to shit in peace? Stand there and keep her company? Should I leave? Should I keep trying to take her blood pressure?–I probably choose to do the most naive thing possible: I remain in the room and make small talk. While she sat on the john. My rationale is that I should get used to the smell of someone else’s poop sooner than later. In retrospect, though, I’m not sure if there was any “therapeutic” rationale for me to be in that room at that time.

Hour 3, 10 a.m.: My feet and lower back are starting to kill me. I look at the clock and laugh that it’s only 10 a.m.

“My” patients this week were:

• a spunky, 60 year old German woman with a deep wound/abscess in her knee. During a dressing change she gladly showed me how deep her wound was by poking a cotton-swab stick right into it; it went in about 3 inches.
• an 80+ year old Chinese woman in palliative care. This means she was no longer being treated for her cancer but was being allowed to die naturally and as comfortably as possible. I talked with her awesome daughter in Chinese. I later learned that their family owns one of my favorite Chinese restaurants in SF, a Buddhist vegetarian place.
• a farmer with very aggressive thyroid cancer. In the 2 days I saw him he went from upbeat and talkative to no longer able to swallow. His wife, his high school sweetheart, was with him the whole time.
• the young 400+ pound woman who was going on her 4th week in the hospital, more for psychosocial treatment than medical.